H5N1 news (bird flu)

[kbutton]

Bird flu stuff…

https://www.cidrap.umn.edu/avian-influenza-bird-flu/avian-flu-detections-dairy-cows-raise-more-key-questions
 

https://www.cdc.gov/flu/avianflu/hpai/hpai-interim-recommendations.html

 

Edited Friday at 02:16 PM by kbutton

[Innisfree]

I was reading about this in the newspaper. Thanks for sharing more information.

[Ausmumof3]

Thanks for starting a separate thread. 
 

The biggest worry is that many chunks of the world do not have the will or ability to deal with something else so soon after Covid.

[prairiewindmomma]

The mammal to mammal transmission is super concerning.

[EKS]

59 minutes ago, Ausmumof3 said:

The biggest worry is that many chunks of the world do not have the will or ability to deal with something else so soon after Covid.

For example, the United States.

[Ausmumof3]

3 minutes ago, EKS said:

For example, the United States.

Australia… UK…

and many others 

People are sick of hearing about viruses and cost of living pressures mean no one has mental space to deal. So I just hope H5N1 decides to go away or self limit

[Innisfree]

Quote

At least one person in Texas has been diagnosed with bird flu following contact with dairy cows presumed to be infected, state officials said on Monday.

The announcement adds a worrying dimension to an outbreak that has affected millions of birds and sea mammals worldwide and, most recently, cows in the United States.

So far, there are no signs that the virus has evolved in ways that would help it spread more easily among people, federal officials have said.

The patient’s primary symptom was conjunctivitis; the individual is being treated with an antiviral drug and is recovering, according to the Centers for Disease Control and Prevention….

The virus has been identified as the same version of H5N1, an influenza subtype, that is circulating in North American birds.

The C.D.C. is working with state health departments to monitor others who may have been in contact with infected birds and animals, the agency said on Monday.

This is only the second case of H5N1 bird flu in people in the United States; the first was in 2022. Experts said that they believe the risk to the general public remains low. But testing and analysis is ongoing, and there are many unanswered questions.

https://www.nytimes.com/2024/04/01/health/bird-flu-cattle-human.html?unlocked_article_code=1.hE0.O3bf.gR6ZJS1-Hvti&smid=url-share (Gifted)

[mommyoffive]

There was a bit about it here

https://caitlinrivers.substack.com/p/outbreak-outlook-national-april-1?utm_source=post-email-title&publication_id=1017072&post_id=142985383&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

• U.S. officials have detected avian influenza A(H5N1) in dairy cows in New Mexico, Texas, Michigan, Idaho and Kansas. H5N1 has been spreading widely in wild birds for several years now, as I’ve reported in previous newsletters. Symptoms in dairy cows include reduced milk production and low appetite. This development follows a recent report of goats contracting bird flu in Minnesota, which marked the first known instance of the virus in domestic ruminants. The U.S. Department of Agriculture and the Food and Drug Administration have determined that the commercial milk supply remains safe, because milk from sick animals is discarded. Moreover, pasteurization is effective at inactivating viruses and bacteria.

  • This situation is worrisome because it affects multiple farms across different states and includes infections in animals not previously affected. While there are clear implications for agriculture, my major concern is the potential for the virus to evolve to spread easily between humans. There is no evidence that this is happening, but any time we see a change in the epidemiology of the virus, I take notice. I’ll be watching this situation closely in the days and weeks ahead.

[mommyoffive]

https://yourlocalepidemiologist.substack.com/p/avian-flu-birds-cows-and-now-a-human?utm_source=cross-post&publication_id=281219&post_id=143171257&utm_campaign=1017072&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

[kbutton]

6 hours ago, mommyoffive said:

https://yourlocalepidemiologist.substack.com/p/avian-flu-birds-cows-and-now-a-human?utm_source=cross-post&publication_id=281219&post_id=143171257&utm_campaign=1017072&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

Let’s hope they don’t hold up shots in red tape if this gets going in people!!!

I think this is mildly optimistic with the don’t knows being big don’t knows.

I’m starting to gradually stock up in a prioritized way. It won’t hurt if nothing happens.

A local news station interviewed a doctor about the steps toward this becoming a concern—he did a good job of making it clear that human to human transmission is the last step in the chain without sounding freaked out. I appreciated the more neutral tone of just describing the transmission chain vs. don’t worry until I tell you to like this newsletter, lol.

[Faith-manor]

3 minutes ago, kbutton said:

Let’s hope they don’t hold up shots in red tape if this gets going in people!!!

I think this is mildly optimistic with the don’t knows being big don’t knows.

I’m starting to gradually stock up in a prioritized way. It won’t hurt if nothing happens.

A local news station interviewed a doctor about the steps toward this becoming a concern—he did a good job of making it clear that human to human transmission is the last step in the chain without sounding freaked out. I appreciated the more neutral tone of just describing the transmission chain vs. don’t worry until I tell you to like this newsletter, lol.

Yes. I appreciate this approach.

That said, we live in an area surrounded by dairy farms, huge dairy operations, and we have had bird flu in the past that decimated flocks, and shut down the county fair for 4H and FFA kids. Realistically, if it is going to be a thing and start going around humans, we will be in a high risk area. So when I get home, I am going to prepare the pantry, put some things in the freezer, and make sure I have what I need for summer gardening, boat fuel so we can use the trolling motor to get out of the channel and past the break water, and plenty of supplies for making several weeks of Lewis' dog food. Then we can just be at home with the grandmothers enjoying spring. We can go to the nursery for flowers as soon as I arrive home, and then moms can happily putter in their flower beds and make up hanging pots which they love to fuss over. 

[kbutton]

From Sharon Astyk on a FB Covid group (no idea who she is!, but this seems well thought out)…not sure I can link vs. copy:

Preparing for the Spread of Avian influenza.

Ok, I know we've been here before, but let's go over the basics on preparedness for another pandemic.  God willing, it won't be needed anytime soon, but there's a solid chance it will.  

So let's review, and talk about how H5N1 is likely to be DIFFERENT than covid, and thus, how to use what we've learned but adapt it.

How to protect yourself against H5N1 IN GENERAL.

1. When there is an avian influenza vaccine, get it.  Current flu vaccines do NOT protect against Avian influenza, although you should get your flu vaccine anyway because it protects against dementia.  

There will, however, be a vaccine fairly soon into the pandemic.  But FLU VACCINES ARE NOT STERILIZING.  Flu, like covid, mutates rapidly, and that's why you need a new flu vaccine every year and some people who get it still get the flu.  The vaccine is excellent at protecting against death and severe disease, but not so hot at protecting against getting the virus.  

My guess is with distribution issues, an H5N1 vaccine will be available to health care workers and essential workers pretty fast, but scaling up to everyone will take a while, and there is every reason to expect multiple waves (Spanish flu came in multiple waves over 18 months) and your vaccine will become less effective over time.  Expect WIDESPREAD inequities - rich nations are already buying up all the production capacity for vaccines that haven't been made yet.  Also in the US expect MASSIVE house opposition to funding for such vaccines.

2. NPIs (Non-Pharmaceutical interventions) - you know, the things that we've spent the last three years telling everyone were terrible and a scarlet letter and hell on earth?  Yeah, those things.   They work - they work SO well that in 2020 we essentially had ZERO flu and at least one flu virus went extinct.  

Masks - best masks are resusable respirators.  Then N95 headloop, next are KF/KN95/94, but even a surgical mask makes a difference (that said, I don't recommend surgical masks, but the best mask is one you will WEAR.)

Limiting crowds 

Avoiding large gatherings

Air cleaning with HEPA (including Corsi-Rosenthal) and/or UV 

C02 monitoring of air to show how much rebreathed air there is.

Ventilation

Closing Schools and other crowded venues (very, very important, because kids get H5N1 WORSE than healthy adults and are more likely to die, but also very politicized and likely to be controversial and delayed in many places.  Be ready to pull your kids.  Seriously.)

Handwashing and sanitizing to protect against fomite transmission (the worries people had about fomite transmission for covid were largely overstated, although fomite transmission does happen, but flu has a higher rate of fomite transmission.)

Biosecurity for animals - especially for farmers or backyard animal keepers, but really anyone with pets - outdoor shoes, sanitization of feet and paws, birds kept indoors or under covered runs, avoid places with bird and animal droppings, hot composting of manure, closing of fairs, petting zoos, etc...

Avoiding raw milk (including from your own animals), careful handling of raw meat (I would be avoiding rare beef for a while) and eggs.  I'd stay away from raw milk cheeses too, sadly.

If you can afford it, your stock up list AND THE STOCK UP LIST OF COMMUNITY INSTITUTIONS should include masks, bleach (my suggestion is a bucket of pool shock chlorine which is much more shelf-stable than bleach and can be made into bleach by adding water - much cheaper and will last for years), hand sanitizer, soap, gloves, and boot covers if working with livestock or travelling in areas with a lot of waterfowl.  

You also might want eye protection, if you don't already wear glasses.  Our eyes are better adapted to H5N1 reception than the rest of us, and it is a common pathway to getting it.  Safety goggles are good, but even plain glass glassess are better than nothing, and there are several studies that show in an airborne pandemic, glasses wearers are somewhat less like to contract the disease.

I cannot emphasize enough how important it is for community institutions with any kind of resources to be helping prepare for this.  Your church, synagogue, mosque, community center, etc... should be preparing for this NOW - working on air cleaning, masks to hand out, safe food supplies for food pantries, etc...  

We know that avian influenza has infected both cats and dogs, so your pets can get it.  Keep cats indoors, and away from poultry.  Avoid walking dogs by waterways (I know, it sucks) and keep them away from dead birds and manure.  

Dogs should stay on leashes.  If it gets bad, you can clean paws with a very dilute bleach solution, but remember, the virus is airborne and spreading animal to animal through the air.  Best to try and keep them away when you can.  For smaller dogs, for folks in crowded areas or with a lot of waterfowl, it might be worth training your dogs to use pee pads sometimes, in case you have to keep them inside at any point.

I would expect there to be some backlash about backyard poultry keeping.  YOU MUST KEEP YOUR BIRDS IN A COVERED RUN, and use basic biosecurity in caring for them.  Given that the current version of HPAI has been found in Grackles and Crows now, I think this means all year round, which sucks, but the other choice is probably a ban on backyard poultry keeping in many areas, or biosecurity teams killing your whole flock.  

If you are looking to secure a supply of eggs, bantam hens or quail that can be moved fully indoors might be a sensible solution for some.

What about the food supply?

Covid obviously affected the supply chain.  But avian influenza is going to affect it A LOT MORE for several reasons.

1. In the most basic sense, a symptom is a decline in milk production and weight loss in cows.  So animals infected are going to be less productive.

2. Right now they are saying they will not slaughter the cows that have been infected.  But they may have to for a number of reasons.  First, the virus had neurological implications for animals, and it may be necessary for humane purposes.  Second, there is likely to be a  large outcry from nations that we export beef to.  

3. Bringing dairies and feedlots up to full biosecurity is going to take time and cost money - some farmers may not find it cost effective and sell off or slaughter herds.

4. It is going to be harder and more expensive to get dairy workers who have to wear full PPE and be exposed to a disease that kills between 10 and 30% of the folks who get it.

4. We are still going to have outbreaks in poultry affecting eggs and meat.  Up to now, we haven't taken them that seriously, beyond slaughtering larger flocks,  but as the virus mutates the risk from factory poultry production grows. 

Here are food products likely to be directly or indirectly affected by a ruminant to ruminant spread:

1. Milk
2. Butter and Cheese
3. Beef 
4. Goat and Lamb (remember, it was found in goats in Michigan as well)
5. Eggs
6. Poultry
7. Vegan milk, egg, cheese, butter and meat substitutes
8. Infant formula (I'm very concerned about this one)
9. Pet food (one in 7 cows in the US is too sick to make it into the human food chain, and most of that goes into pet food, and the pet market makes feedlot agriculture economically viable.)

Understand, this is just for the current level of ruminant and ruminant to ruminant spread.  I would almost certainly suspect it will be found in pigs within a month or so - and then pork prices will rise as well (and they may anyway as it is perceived as a safe meat) but we'll have bigger problems than pork.

Things to stock up on if you can - shelf stable and powdered milk if you use them, same with eggs, canned or preserved meats, infant formula if you have a baby (and if you can afford it, even if you are nursing, remember you could become ill and be unable to nurse in an epidemic - a can or two of formula is a good idea, and you can always donate it to a desperately grateful food pantry.)  

Shifting to non-animal sources of protein, dairy and egg makes a lot of sense, but expect to be among many doing so, and see corresponding shortages and supply chain issues with non-dairy milks, flaxseed, vegan butter and cheese.  If you are already a vegan or use these regularly, you might want to prepare for supply chain disruptions.

I would also expect this to have knock-on effects that are harder to predict - for example, if countries close to US beef exports, beef prices may fall at first.  If cases are found in slaughterhouses or processing facilities, it might affect other meats as well, and a bunch of things we won't see until they show up.

ALL OF THIS IS FOR THE CURRENT LEVEL OF SPREAD - into ruminants or between ruminants, with occasional animal-to-human cases, rather than sustained human to human spread.  Just to be clear, I expect some societal disruption EVEN IF it does not get to human to human spread.

Right this minute, I suspect one of three things is going to happen next, and these are the possible timelines.

1. H5N1 will be found widely in domestic animal herds.  Everyone will freak out.  A few cases, maybe a dozen or so animal-to-human cases will be found, but no H2H spread yet.  There will be some new biosecurity mechanisms, and price spikes, and gradually everyone will settle down, mostly forget about it, and get lax about biosecurity, and then it will cross into humans next winter, next year or a year or two.  This is the most likely scenario.

2. We will find that the mutation that permitted widespread spread into humans and made cow-to-cow transmission probable makes it easier to get into humans, and will either find that human to human spread is ALREADY occurring in the next couple of weeks.  

Before covid, I think sustained human to human transmission was unlikely to pass unnoticed, but covid can cover a myriad of sins, so there is a small but non-zero chance that this has ALREADY caused the virus to shift enough for some increased (but maybe not easy) H2H transmission, and that by summer or early fall, we'll have hit full-scale H2H.

For many months now, I have been reminding us all that WE ARE MAMMALS and that H5N1 is destroying whole populations of animals and transmitting between them.  

3. It gets into pigs.  Odds are it got there already (there is some evidence of PRIOR appearance in pigs, so we know it can) and shortly after recombines with human flu and we're all fucked.  Timeline just depends on when - I'd say within the year at the latest and maybe last Thursday.

I don't see a single plausible scenario where this DOESN'T turn into a human pandemic in the next few years.  The big question is whether it turns into one in the next few MONTHS.

We know, however, from immune surveys, that there have been undetected cases.  Avian influenza ranges from deadly to mild - for example, the only symptom of the current TX case is conjunctivitis, which suggests infection via eye.  

There were five recent cases in Cambodia, including two deaths.  One of the deaths was in a three year old child, and their brother, a teen, was asymptomatic but positive.  All of which means that it will be perfectly possible for some people to be walking around spreading the virus without being aware they have it.  Moreover, we know that influenza has a short asymptomatic spread period.  This is good, because those asymptomatic cases means that half of everyone who gets it won't die, but bad, because it enables spread.

So while the current known Case Fatality Rate is between 52 and 60% for cases worldwide, the actual IFR will be expected to be quite a bit lower.  WHO estimate is that it will come out around 12-33% of all cases.  So somewhere between one in ten and one in three of those who get H5N1 can be expected to die.  The numbers are HIGHER in young children and the elderly.

It is also worth noting that during the Spanish Flu, children and the elderly actually did better, as the Spanish flu induced cytokine storms, which caused rapid progression to death in those who were young and had HEALTHY immune systems.  It was the strong immune response that killed them.  

However, we can expect that many of the people who get covid will not have an overactive immune response, but an ineffective one, due to documented immune damage from covid.  Remember, covid damages your immune system for 6-8 months.  Immune damaged people have milder initial infections, but are unable to clear the virus, and of course, more likely to become very ill or die.

I would expect a human to human avian influenza outbreak to come in waves, probably an initial wave with comparatively lower rates of transmission, then we all say "that wasn't so bad" and it comes back much worse (a la both covid and spanish flu.)

Thus, even if you don't get sick, you will need to be prepared for the following.

1. Large scale supply chain disruptions globally - the ones we had with covid were just for practice.  I would also expect SUSTAINED supply chain disruptions, or waves of disruption, but worst in the winter.  

2. Higher mortality due to coinfection with covid and other viruses - that is, Avian flu is bad enough, but covid plus flu plus RSV even worse.  A winter wave will be particularly dangerous this way, and I would assume one in the next few winters.

3. Disruptions in essential services including trash pickup, local government services, national government services, court services, water treatment, and potentially power.  All those things are run by PEOPLE.

4. Overwhelmed hospitals and medical centers.  Almost half of all people who got H5N1 required ICU level care.  This is going to be very tough on an already overburdened medical system.

5. Shortages of PPE...again.

6. Shutdowns - and I know some of you think we won't shutdown, but I don't think we'll have a choice.  Ultimately, an avian influenza pandemic will be so disruptive people will have few choices.  However, we are unlikely to see the level of pandemic supports covid received.

7. In the US widespread initial death, particularly in Red states (the ones that produce a lot of our food, btw) from people who believe passionately that masks and H5N1 are a psyop.  They will change their minds, but probably not right away.

8. Political consquences.  A LOT of them, many of them hard to forsee because my best guess for the timing of H2H transmission is next fall and winter - coincident with the election.

9. Repeated waves of death, illness and disruption going on at LEAST a year and a half and maybe much longer.

10. Closed schools (with the usual tossing all the responsibility back on women and the informal economy), closed businesses, economic issues.

11. Widespread pet abandonment as the fear of getting H5N1 from your pet becomes an issue.

12. Destruction of family farm economies for small farms that rely on livestock.

We are going to need food, basic goods, community support and care systems for the most vulnerable, and the ability for our neighbors and our community to work together.  There's a TON of work to do, and it is going to take a long time, and  our response to  covid has actually undermined our preparedness in many cases.  We'd best get cracking.  And like covid, this one is a marathon, not a sprint.  

Also remember human beings really, really suck at dealing with more than one crisis at a time.  But none of us is allowed to forget that covid and climate change and political instability are not going away just because we've managed to get ourselves into another pandemic.

[Faith-manor]

Sharon Astyk is a former professor now subsistence farmer in New York. I don't know what her qualifications are for reliability about an H5N1 pandemic. 

I do feel that it isn't far fetched. Destruction of rainforest and other elements of climate change make frequent pandemics a new normal.

That post was a lot to process.

[Ausmumof3]

5 hours ago, Faith-manor said:

Yes. I appreciate this approach.

That said, we live in an area surrounded by dairy farms, huge dairy operations, and we have had bird flu in the past that decimated flocks, and shut down the county fair for 4H and FFA kids. Realistically, if it is going to be a thing and start going around humans, we will be in a high risk area. So when I get home, I am going to prepare the pantry, put some things in the freezer, and make sure I have what I need for summer gardening, boat fuel so we can use the trolling motor to get out of the channel and past the break water, and plenty of supplies for making several weeks of Lewis' dog food. Then we can just be at home with the grandmothers enjoying spring. We can go to the nursery for flowers as soon as I arrive home, and then moms can happily putter in their flower beds and make up hanging pots which they love to fuss over. 

This is the thing. It’s all very reassuring about human to human spread etc. less reassuring for those who work closely with birds and livestock… 

[Ausmumof3]

46 minutes ago, Faith-manor said:

Sharon Astyk is a former professor now subsistence farmer in New York. I don't know what her qualifications are for reliability about an H5N1 pandemic. 

I do feel that it isn't far fetched. Destruction of rainforest and other elements of climate change make frequent pandemics a new normal.

That post was a lot to process.

I definitely do not have the headspace for this…

Im going to plant some more vegetables, order some masks, replace the sanitiser and hope it all goes away!!!

[Faith-manor]

1 hour ago, Ausmumof3 said:

I definitely do not have the headspace for this…

Im going to plant some more vegetables, order some masks, replace the sanitiser and hope it all goes away!!!

I agree. And the common person has very little more they can do. The mitigations and interventions are a matter of public policy, a matter of leadership. Our leaders don't give a flying fig. So my plan is as the world seems to regularly go to hell in a handbasket is to just try to provide for my own...masks for my kids and their partners, for the grandkids, important items stocked, ways of keeping morale up, disinfection and over the counter items on hand for all, and a bigger garden, and harvest preserve sharing among them so they have some back up stock if things get scarce again. There just isn't a lot else we can do so there is zero point in obsessing about it, and making mental health tank into the abyss. I am heart broken for the world my grandsons are inheriting. World leaders had many opportunities to solve so very many problems and save our kids from the earth burning, and that was apparently way too much to ask of these !@#$$&#^#^!%%! a$$holes!

Edited April 3 by Faith-manor

[prairiewindmomma]

In our current political environment I only see them closing schools if a significant number of kids are dying…meaning at least a couple in every grade. And, I think that is unlikely as well.

[Faith-manor]

23 minutes ago, prairiewindmomma said:

In our current political environment I only see them closing schools if a significant number of kids are dying…meaning at least a couple in every grade. And, I think that is unlikely as well.

I think they will close them when so many staff members have died that they have no hope of keeping them open. It isn't like the powers that be have an ounce of respect for faculty and school staff. Not sure they give a rat's rear about kids at all. Sigh.

[Ausmumof3]

BNO reporting on Twitter that three cats that have died in Texas were also confirmed to have bird flu. Hopefully people are able to keep their cats indoors and reduce risk.

[Mom_to3]

 Don' worry! Ashish Jha is on it - it's all good and we are in competent hands: 

 

[Happy2BaMom]

I'm glad the CDC spun on a dime to get this analysis completed.

I'm relieved that there's no change (at least yet) to allow human-to-human transmission (although part of me wonders how they know that?).

I find the "one change that allows the virus to better infect mammals" to be quite alarming (like....humans are mammals.....). This is not good news, for multiple reasons.

Edited April 4 by Happy2BaMom

[Happy2BaMom]

One other side note for pandemic-cautious people to file away in their brain while they watch news & make preps.....a *lot* of hospital-based health care workers changed gears after the height(s) of the Covid pandemic. Many left their jobs, left the field, left the hospital, left the country....left bedside care however they could. Many of those who stayed changed gears in other ways - many nurses are now travelers, bound only as far as the end of the contract while they stockpile money. A not-insignificant-number of hospital-based doctors shifted or are shifting to per-diem or other short-term contracts. I've read several articles and a lot of SM-based posts about the "never-again" HCW crowd, meaning, at the first sight of another pandemic, a bunch more hospital-based HCW are gonna punch before they pay the price. While some people might blame them, the truth is that Covid knocked the stuffing out of a ton of HCWs. They suffered too much burnout, too many ridiculous expectations, and far too much emotional and mental (and sometimes physical) abuse.

TL/DR: Expect that the level of emergency / hospital-based health care to be sh*t when the next pandemic rolls around.

Edited April 4 by Happy2BaMom

[Faith-manor]

10 minutes ago, Happy2BaMom said:

One other side note for pandemic-cautious people to file away in their brain while they watch news & make preps.....a *lot* of hospital-based health care workers changed gears after the height(s) of the Covid pandemic. Many left their jobs, left the field, left the hospital, left the country....left bedside care however they could. Many of those who stayed changed gears in other ways - many nurses are now travelers, bound only as far as the end of the contract while they stockpile money. A not-insignificant-number of hospital-based doctors shifted or are shifting to per-diem or other short-term contracts. I've read several articles and a lot of SM-based posts about the "never-again" HCW crowd, meaning, at the first sight of another pandemic, a bunch more hospital-based HCW are gonna punch before they pay the price. While some people might blame them, the truth is that Covid knocked the stuffing out of a ton of HCWs. They suffered too much burnout, too many ridiculous expectations, and far too much emotional and mental (and sometimes physical) abuse.

TL/DR: Expect that the level of emergency / hospital-based health care to be sh*t when the next pandemic rolls around.

Agreed. The next one is going to bring this country to its knees.

[kbutton]

4 hours ago, Happy2BaMom said:

They suffered too much burnout, too many ridiculous expectations, and far too much emotional and mental (and sometimes physical) abuse.

I have so many thoughts on this. DH is a HCW. Around here, much of the abuse was self-inflicted or came from other coworkers—HCWs were not always masking in the hospital (taking masks off when not around patients) and definitely not masking in their personal lives. Many changed jobs to avoid getting vaccinated.

It was super difficult for DH to watch people be very sick and die when he knew that people we know were spreading the kinds of lies that we’re making people so sick in the first place.

I know there were other kinds of burnout too, but I don’t feel at all sorry for HCWs who bring it upon themselves. 

I expect it to be terrible, but if I hear non-masking or anti-vax HCWs whine and spread conspiracies…

We better have PPE and support though. I am fine complaining about those kinds of things!

I think they will loosen restrictions in hospitals next time around to retain workers, and we’ll have insane spread in healthcare settings and nursing homes. They might do better in children’s hospitals (ours are better with protocols than the adult hospitals). That’s my two cents.

[kbutton]

https://www.politico.com/live-updates/2024/04/02/congress/hill-briefed-on-avian-flu-health-agencies-00150212?fbclid=IwAR1I0xaFsrIqZpyouNveNw8fIQ99epLm_P6248uUcKV-UuwRNqd64UAZADc_aem_AfA_sWQAyChvyR4tFR7naKL263XBUxL0ecmctueyYA9RuIBCTbmh1tbuaBk8LO0ZDzM
 

How about a round of, “I found it first” where we spot problematic and probably currently true statements that will bite us in the butt later?!? This article is full of them.

I’ll go first: “Demetre Daskalakis, director of the CDC’s National Center for Immunization and Respiratory Diseases, said on the call that while the health risk to the public is low, people with long exposure to infected birds or livestock may be at greater risk of infection.”

I predict the word long used here is going to bite us later.

[KSera]

12 minutes ago, kbutton said:

How about a round of, “I found it first” where we spot problematic and probably currently true statements that will bite us in the butt later?!? This article is full of them.

I’m thinking that

“it is suspected that cow-to-cow transmission may be occurring in milking facilities.”

may eventually be incompatible with 
 

“We do not expect a significant impact on the price of milk and other dairy products,” Prater said on the call.

[Happy2BaMom]

10 hours ago, Faith-manor said:

Agreed. The next one is going to bring this country to its knees.

That definitely could happen. Or the train(s) of late-stage capitalistic empire(s) could just roll on for some time to come yet, regardless of the bodies lining the streets. I definitely think many more people will die who might not have otherwise, though, due to further breakdowns in the HC system.

 

5 hours ago, kbutton said:

I have so many thoughts on this. DH is a HCW. Around here, much of the abuse was self-inflicted or came from other coworkers—HCWs were not always masking in the hospital (taking masks off when not around patients) and definitely not masking in their personal lives. Many changed jobs to avoid getting vaccinated.

It was super difficult for DH to watch people be very sick and die when he knew that people we know were spreading the kinds of lies that we’re making people so sick in the first place.

I know there were other kinds of burnout too, but I don’t feel at all sorry for HCWs who bring it upon themselves. 

I expect it to be terrible, but if I hear non-masking or anti-vax HCWs whine and spread conspiracies…

We better have PPE and support though. I am fine complaining about those kinds of things!

I think they will loosen restrictions in hospitals next time around to retain workers, and we’ll have insane spread in healthcare settings and nursing homes. They might do better in children’s hospitals (ours are better with protocols than the adult hospitals). That’s my two cents.

 Very good points / reminder that there are many different complexities re: this issue. If I remember right, you were/are in a rural area which had a "covid is not real / overblown / conspiracy / etc" culture. My circle has been/is more exposure to urban/suburban HCWs, many of whom were on the the front lines of dealing with transfers from such areas. My HCW cousin (as one example) was kicked at, spit at, called a murderer (multiple times), followed to her car, harassed while wearing scrubs (her hospital actually banned workers from wearing them outside of hospital grounds due to ongoing harassment & safety issues), and more. It was effing ridiculous.

And you are probably right that hospitals, already short-staffed, will not have the stomach for implementing mandates, etc, the next time.

Ugh. We are weakening from within.

 

Edited April 5 by Happy2BaMom

[Happy2BaMom]

3 hours ago, kbutton said:

How about a round of, “I found it first” where we spot problematic and probably currently true statements that will bite us in the butt later?!? This article is full of them.

 

I'm still stuck on "one change that allows the virus to better infect mammals....".

Echoes of prophecy? But I may just have watched too many dystopian sci fi movies.

[kbutton]

16 minutes ago, Happy2BaMom said:

Very good points / reminder that there are many different complexities re: this issue. If I remember right, you were/are in a rural area which had a "covid is not real / overblown / conspiracy / etc" culture.

Grew up rural. Live in suburbia with major medical centers in the nearby cities (one of the best children’s hospital in the nation is a half hour away if there isn’t a lot of traffic).

Our state had a lot of the originators of the conspiracy theories, and I am in a deeply red county. We had a local “expert” spinning off Covid conspiracies and political conspiracies simultaneously. Multi-talented, I tell you. Nurses embracing and spreading conspiracies. It was nuts. Self-inflicted stupidity, and of course, higher death rates than other regions along party lines.

[happypamama]

This thread has me worried. DH's job involves being in old buildings a lot, and they are full of animal and bird droppings. What can he do to stay safe if this spreads even more, other than wearing respirator and glasses and gloves/washing hands (not that he can always do much of that on the job sites)? I don't think he normally wears a respirator unless it's a known hazard or super dusty. Here's hoping that a vaccine will be available for him. (Person to person worries me less than the birds -- the birds have me really scared for him because he cannot avoid old buildings at all.)

[kbutton]

4 minutes ago, happypamama said:

This thread has me worried. DH's job involves being in old buildings a lot, and they are full of animal and bird droppings. What can he do to stay safe if this spreads even more, other than wearing respirator and glasses and gloves/washing hands (not that he can always do much of that on the job sites)? I don't think he normally wears a respirator unless it's a known hazard or super dusty. Here's hoping that a vaccine will be available for him. (Person to person worries me less than the birds -- the birds have me really scared for him because he cannot avoid old buildings at all.)

He can wear head to toe PPE like what people administering Covid tests did early in the pandemic. He might have to bring wash water/wipes/sanitizer with him on job sites. I assume that the bird droppings/dead birds are largely fomite contamination if left undisturbed, but I don’t know for sure. He might need to work really hard at decontamination for his stuff and his vehicle.

I’m sorry! That’s hard!

[Ausmumof3]

 

[Faith-manor]

Why do I have this sneaking feeling that this thread is going to be a tragic number of pages😭🤯

[Mom_to3]

7 hours ago, kbutton said:

 

How about a round of, “I found it first” where we spot problematic and probably currently true statements that will bite us in the butt later?!? This article is full of them.

 

CDC's Cohen: "Our treatment, which is Tamiflu, which we have both doses in stockpile and around the country, works." https://www.npr.org/2024/04/03/1242585330/bird-flu-avian-cows-eggs-milk-idaho-kansas-texas-michigan-new-mexico-cdc

I seem to remember that in H7N9 cases in China (and to a lesser extent in the Swine flu outbreak of 2009) they were giving double the dose of Tamiflu, and mortality was still incredibly high.

[Happy2BaMom]

9 hours ago, happypamama said:

This thread has me worried. DH's job involves being in old buildings a lot, and they are full of animal and bird droppings. What can he do to stay safe if this spreads even more, other than wearing respirator and glasses and gloves/washing hands (not that he can always do much of that on the job sites)? I don't think he normally wears a respirator unless it's a known hazard or super dusty. Here's hoping that a vaccine will be available for him. (Person to person worries me less than the birds -- the birds have me really scared for him because he cannot avoid old buildings at all.)

The CDC FAQs on H5N1 might be of help to you.

The CDC site also states, "(H5N1) viruses do not currently have an ability to easily infect the human upper respiratory tract, which would be needed to increase the risk of transmission to people", which answers one of my questions above. 

I think the risk to the average person is quite low right now, but we're 100% banking that a virus that recently figured out how to jump from bird to multiple genuses of mammals is not going to mutate to infecting via airway contagion. And maybe that's a large enough jump that it won't happen for several/many years. Or not.

Having said that, I do now notice that the CDC statement includes the word, "easily", which might fall under the category of "I found it first", lol.

Edited April 5 by Happy2BaMom

[mommyoffive]

Item 1. Bird flu infects a US resident.

For the second time ever, H5N1 influenza (“bird flu”) has infected someone on US soil. The patient works with cows, where the disease has been found. The case occurred in Texas and the symptoms were described as mild, with eye redness as the only outward sign of illness. The previous case was in 2022—a Colorado man who worked with poultry—and was also mild.

While it’s nice to hear that two cases were basically clinically forgettable, we don’t know how many cases out of 100 would be serious. Remember, Covid-19 probably had a fatality rate of around 1 in 200 prior to vaccines and therapeutics. But, as my friend Dr. Jen Brokaw reminded me early in the Covid-19 outbreak, a huge number (the world population) multiplied by a small one (the case fatality rate) equals a pretty large one.

The CDC is expressing confidence. In reality, nobody knows anything about what will happen next. This could be a harbinger of something bad, or merely a warning shot. Watching and waiting.

https://insidemedicine.substack.com/p/inside-medicine-five-on-friday-april?utm_source=post-email-title&publication_id=1183526&post_id=143279649&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email

 

[Katy]

I got out of nursing in the last flu epidemic. I was required to get 4 flu shots at work (some for regular flu, some for the new strain), the last one was a “bad batch” and now I can’t get another flu shot because I’m at high risk. 

At the time we (hospital staff) were told that bird and swine flu epidemics are common and occur at least every 10 years. They’re often noteworthy for killing the young and the pregnant, though at the time most of the patients we had hospitalized were male and either over 45, HIV positive, or both. 

Flu reaches pandemic proportions much less often than epidemic. I know there has been speculation in the past that it was about every 100 years, but since then I’ve read theories that when it got bad it was only because of extenuating factors. I don’t recall the details but in 1918 it wasn’t just WWI, there were also concerns with nutrition, sanitation, and polio. 

My point is that there’s no need to panic. Keep supplies on hand, but I wouldn’t stress about that unless & until we get information like we did at the beginning of Covid-19 that hundreds or thousands are dying from the flu. Until then, wear a mask out of courtesy if you’re sick. Consider it all the time if you’re immunocompromised. We’re having supply chain issues anyway so keep some emergency food, toilet paper, and medicines on hand. But otherwise don’t worry so much. Flu epidemics are predictable and generally nothing like Covid-19. 

[73349]

On 4/4/2024 at 10:03 PM, happypamama said:

This thread has me worried. DH's job involves being in old buildings a lot, and they are full of animal and bird droppings. What can he do to stay safe if this spreads even more, other than wearing respirator and glasses and gloves/washing hands (not that he can always do much of that on the job sites)? I don't think he normally wears a respirator unless it's a known hazard or super dusty. Here's hoping that a vaccine will be available for him. (Person to person worries me less than the birds -- the birds have me really scared for him because he cannot avoid old buildings at all.)

Going along with kbutton's suggestions, I'd have him keep a roll of trash bags in his vehicle, and ensure that PPE includes disposable shoe coverings and/or a tub with bleach and water to step into for a few seconds before getting back into the vehicle.

[Happy2BaMom]

On 4/5/2024 at 9:56 AM, Katy said:

I got out of nursing in the last flu epidemic. I was required to get 4 flu shots at work (some for regular flu, some for the new strain), the last one was a “bad batch” and now I can’t get another flu shot because I’m at high risk. 

At the time we (hospital staff) were told that bird and swine flu epidemics are common and occur at least every 10 years. They’re often noteworthy for killing the young and the pregnant, though at the time most of the patients we had hospitalized were male and either over 45, HIV positive, or both. 

Flu reaches pandemic proportions much less often than epidemic. I know there has been speculation in the past that it was about every 100 years, but since then I’ve read theories that when it got bad it was only because of extenuating factors. I don’t recall the details but in 1918 it wasn’t just WWI, there were also concerns with nutrition, sanitation, and polio. 

My point is that there’s no need to panic. Keep supplies on hand, but I wouldn’t stress about that unless & until we get information like we did at the beginning of Covid-19 that hundreds or thousands are dying from the flu. Until then, wear a mask out of courtesy if you’re sick. Consider it all the time if you’re immunocompromised. We’re having supply chain issues anyway so keep some emergency food, toilet paper, and medicines on hand. But otherwise don’t worry so much. Flu epidemics are predictable and generally nothing like Covid-19. 

I recognize I & many others in this thread are definitely on the highly-to-mostly-cautious side of the pendulum, but I don't think most aren't panicking. I haven't altered my life in any way and don't intend to, but I am closely watching H1N5 news.

I'm confused by the statement from your hospital. To my knowledge, there has never been a human epidemic from a bird flu, or even a significant outbreak, and I was unable to find any evidence to that effect by searching, although I recognize that there might be a bird flu genetic lineage in one of the flu virus mixtures. I think the animal flu-to-human pipeline has been through pigs, not birds.

I respectfully disagree that H1N5 is similar to a regular flu virus or epidemic. The Swine Flu epidemic of 2009 had an estimated CFR of 2%-8% (there are entire research articles detailing the difficulty in computing an exact CFR for this virus, as so much depends on country, age, underlying conditions, and means of recording deaths & illnesses), but no studies that I know of had a CFR of >10%, and in modernized countries, the death rate was typically <2%. For those humans who have become infected with H1N5, the CFR has been between ~50 - 56%. The few dozen-to-hundreds sporadic human infections with other bird flu viruses (not H1N5) have still usually had CFRs of ~40%. While I don't believe anyone is calculating CFRs in mammals affected with H1N5, the virus has caused widespread deaths in most of the mammals who've become infected since H1N5 made the jump. (ETA: even the Covid CFR, in the most deadly stages, is estimated to 8-9%, although estimates vary widely.)

The CDC/WHO/etc have been clear that H1N5 is not a fit for our respiratory receptacles (not sure if I'm saying that correctly), so, as long as that remains the same, humans are really pretty safe, and, for that, we can all be grateful.

 

Edited April 8 by Happy2BaMom
grammar

[Matryoshka]

49 minutes ago, Happy2BaMom said:

While I don't believe anyone is calculating CFRs in mammals affected with H1N5, the virus has caused widespread deaths in most of the mammals who've become infected since H1N5 made the jump.

Apparently someone has for cats - glad my kitty stays indoors!

https://www.dailykos.com/stories/2024/4/6/2233826/--H5N1-now-confirmed-in-11-US-farms-Cats-die-within-48-hours

I'm still wearing my mask out in public because Covid,  and another upside is that will block any other airborne virus as well (and literally everything is less contagious than covid...)  

Edited April 8 by Matryoshka

[prairiewindmomma]

I think the concern is that if infection becomes widespread in cattle, it will jump to swine fairly rapidly. Humans are (to make a cannibal joke) remarkably like long pig. Widespread swine disease will make it much easier to jump to and spread among humans.

 

Edited May 13 by prairiewindmomma

[kbutton]

https://yourlocalepidemiologist.substack.com/p/state-of-affairs-april-9?utm_source=post-email-title&publication_id=281219&post_id=143250082&utm_campaign=email-post-title&isFreemail=true&r=q2z70&triedRedirect=true&utm_medium=email
 

The bird flu update in this newsletter says testing suggests that the dairy cows are infected with the same strain and probably passing it udder to udder via milking machines. IIRC, the “new” infections in an Ohio heard are from cows that were brought in from TX (from another article).

[kbutton]

This is nuts when it’s confirmed to be from birds…

https://www.bovinevetonline.com/news/industry/aabp-decides-reference-cattle-disease-bovine-influenza-virus-biav?fbclid=IwAR0wg43bhf0BxOCNmNBtHI6MX2EDzYzla87v_2J2emQ0uwi-T74p_9hG96c_aem_AXNKPH7HBxC6_pSRtkhA9OP3aBrtoOs5duGEeHpI504ESZHW06qbX7456d-YQ66MHd0

[kbutton]

From TACT: https://tactnowinfo.substack.com/p/h5n1-avian-influenza-a-critical-update?utm_campaign=post&utm_medium=web&fbclid=IwAR2dmVBphT7hyim59ovIMfsF4SAQI0P6ZVN62Zs6WfzXIExb10ll4ycw6d0_aem_AXMcFDLtpdhX0p_zYrBiPwdrtTR1clFx0zbp7LTkej9YL472n2SPL49b1aPFPU2g4Tc&triedRedirect=true

I didn’t read it yet, but this group has good Covid information, and I didn’t want to lost track of this.

[Ausmumof3]

https://www.cbsnews.com/newyork/news/bird-flu-new-york-city/
 

NEW YORK -- Bird flu has been detected in some birds found in New York City parks and green spaces.

Health officials are growing more concerned about the disease and warn New Yorkers to keep their distance from wildlife.

Philip Meade, a postdoctoral fellow at Icahn School of Medicine, says bird flu has been found in several geese, a peregrine falcon, a red-tailed hawk and a chicken in Marcus Garvey Park in Manhattan.

[Corraleno]

On 4/9/2024 at 1:40 PM, kbutton said:

This is nuts when it’s confirmed to be from birds…

https://www.bovinevetonline.com/news/industry/aabp-decides-reference-cattle-disease-bovine-influenza-virus-biav?fbclid=IwAR0wg43bhf0BxOCNmNBtHI6MX2EDzYzla87v_2J2emQ0uwi-T74p_9hG96c_aem_AXNKPH7HBxC6_pSRtkhA9OP3aBrtoOs5duGEeHpI504ESZHW06qbX7456d-YQ66MHd0

At least they're coming right out and admitting that they're pretending it's a different disease in order "to maintain confidence in the safety and accessibility of beef and dairy products for consumers." <eyeroll>

[Corraleno]

On 4/8/2024 at 5:31 AM, Happy2BaMom said:

To my knowledge, there has never been a human epidemic from a bird flu, or even a significant outbreak, and I was unable to find any evidence to that effect by searching, although I recognize that there might be a bird flu genetic lineage in one of the flu virus mixtures. I think the animal flu-to-human pipeline has been through pigs, not birds.

From the CDC:

"The ‘Spanish’ influenza H1N1 pandemic of 1918-1919 killed an estimated 50-100 million people worldwide. Although the virus was not isolated during 1918-1919, when the technology was available the genetic sequence was later determined to be an avian-like H1N1 virus."

"In February 1957, a new influenza A(H2N2) virus emerged in people in East Asia, triggering a pandemic (“Asian Flu”). This H2N2 virus was comprised of three different genes from an H2N2 virus that originated from an avian influenza A virus. ... The estimated number of deaths was 1.1 million worldwide and 116,000 in the United States."

[kbutton]

https://www.reuters.com/business/healthcare-pharmaceuticals/bird-flu-pushes-us-dairy-farmers-ban-visitors-chop-trees-2024-04-11/?fbclid=IwAR2iUVE2urx6TrWMXYvyItN9YY-omTomgNTCoukajZvyr4ZOj_M0usoX2CE_aem_AZ7-NEH3w5KN0b9N5JZaUUkJK3_-Su-jakw52vMESMcSlqmLGTcJVPbIhzfkHn3ieRM
Has some information about enhanced bio security on farms.

[Happy2BaMom]

On 4/10/2024 at 8:45 PM, Corraleno said:

From the CDC:

"The ‘Spanish’ influenza H1N1 pandemic of 1918-1919 killed an estimated 50-100 million people worldwide. Although the virus was not isolated during 1918-1919, when the technology was available the genetic sequence was later determined to be an avian-like H1N1 virus."

"In February 1957, a new influenza A(H2N2) virus emerged in people in East Asia, triggering a pandemic (“Asian Flu”). This H2N2 virus was comprised of three different genes from an H2N2 virus that originated from an avian influenza A virus. ... The estimated number of deaths was 1.1 million worldwide and 116,000 in the United States."

Yes. It's interesting, but it still doesn't sound like they can confirm that either were specifically a bird flu that jumped to humans. Maybe more in the second than the first, but it's still not a direct leap.

Either way, it's still a long way from Katy's hospital telling her that bird (& swine) flu epidemics were common and occur about every 10 years.

[Carrie12345]

On 4/2/2024 at 5:06 PM, kbutton said:

Biosecurity for animals - especially for farmers or backyard animal keepers, but really anyone with pets - outdoor shoes, sanitization of feet and paws, birds kept indoors or under covered runs, avoid places with bird and animal droppings, hot composting of manure, closing of fairs, petting zoos, etc...

Sigh. I’m just catching up on this now. My relatively country property is COVERED in poo. The backyard area we use for fun is typically okay, because animals prefer the woods or our lovely clover front yard, so of course that’s where we primarily walk our dogs (and pick up after them, but not after deer, foxes, coyotes, bears, outdoor and feral cats, etc.). And all the birds are everywhere, always.
We’re generally not indoor shoe wearers for that reason and more, but there are always times of “I forgot my keys” or carrying in a large package. Or running through the garage without shoes. The 4lb dog is easy to sanitize, but not so much the high-arousal, high-anxiety GSD who hates to have his feet touched. I’m still nursing a bruise from his last nail trim!

Honestly, I’ve been trying to maintain a slight denial position. Covid seemed easier to avoid. When our family all had the swine flu (minus the youngest, born over a year later,) we really didn’t know it was a big deal. I was drowning in momming and not the news. It was awful, but we were treated and fine. Ignorance was rather blissful. I kinda get how people want to live that way.

We’ve remained pretty pandemic prepared, but this does present an added layer. No pun intended as I share that the one thing I did lean into was preserving eggs, so I’m glad for that.