Coronavirus Files: Bird flu stirs worries, but it’s too soon to panic

Published on
February 13, 2023

H5N1 influenza is already causing problems in birds, leading to the culling of 58 million poultry in the U.S. and driving up the price of eggs. It can be deadly in people, but humans usually catch it directly from birds. The ongoing fear is that the virus might develop the ability to pass easily between people, as the coronavirus did.

According to a January report in the journal Eurosurveillance, bird flu infected mink in a farm in Spain last fall. The report has raised alarm bells because the virus seems likely to have spread directly between the animals.

“The events mark the first large H5N1 outbreaks potentially driven by mammal-to-mammal transmission,” writes Jennifer Abbasi at JAMA Network

The virus found in the minks also contained a mutation that might indicate it’s adapting to infect mammal airways.

But it isn’t time to panic, reports Emily Anthes at The New York Times

The infected mink were culled, and there’s no evidence they passed the virus to any people.

“Should we freak out about this? No,” Dr. Chrissy Eckstrand, a veterinary pathologist at Washington State, told Anthes. “But should we stay vigilant and prepared? I think absolutely we should.”

Experts who spoke with STAT’s Helen Branswell agreed it’s difficult to forecast how H5N1 might impact people. 

“Anyone who tries to predict anything about influenza is a bit foolish and hasn’t been in the field very long,” said epidemiologist Keiji Fukuda.

During the current bird flu outbreak, there has only been one human infection recorded in the U.S. so far. 

The U.S. has bird flu vaccines at the ready should the virus start spreading between people, reports The Washington Post.

Black Americans struggle with long COVID

ABC News put the spotlight on racial bias in COVID treatment last week with its report “Being Black with Long COVID.”

“I had several white male doctors sit at my bedside and ask me, ‘Are you sure there’s nothing personal going on in your life? Are you sure? Is it a relationship issue? Was it a job issue?’” said Chimére Smith, a former teacher who sought medical attention for persistent post-COVID symptoms, including blindness in her left eye.

It wasn’t until she saw a Black female doctor, more than a year into her medical journey, that Smith says she was taken seriously.

The latest data from the U.S. Census Bureau Household Pulse Survey indicate that 28.7% of Black respondents said they’d had or have long COVID, and 34.6 % of Black respondents with long COVID said it severely limited their activities, reports Mary Kekatos for ABC

In comparison, 31.7% of Hispanic adults and 27.6% of white adults reported experiencing long COVID.

Dr. Panagis Galiatsatos of the Johns Hopkins Post-Acute COVID-19 Team told ABC that unconscious bias among physicians may lead them to dismiss the symptoms of Black patients.

An even bigger issue, Smith said, is access for Black people to medical information, transport to clinics, and money and insurance to cover medical care.

Galiatsos said fewer than 10% of patients in his long COVID clinic are Black. 

“So many of our patients that we’ve taken on have had to go through several insurance authorizations just to get a referral to come to us,” he said.

New COVID treatment unlikely to receive US authorization

An experimental treatment halved hospitalizations for COVID-19, but don’t expect it to reach U.S. pharmacies anytime soon, writes Benjamin Mueller at The New York Times.

The medicine is a single injection of interferon lambda, a version of a natural human molecule that amplifies antiviral action in the respiratory tract. 

In a study of nearly 2,000 people in Brazil and Canada, the medication reduced the need for hospitalization in vaccinated and unvaccinated individuals, during both the delta and omicron waves. The findings were published in The New England Journal of Medicine.

Because it activates the body’s own immune system, interferon lambda should work on any variant, or any respiratory virus. 

The coronavirus would be unlikely to evolve resistance to the treatment, reports Ingrid Hein at MedPage Today.

Most patients in the study were at high risk from COVID, due to age or other medical conditions. Providing the injection within a week of symptom onset in vaccinated people reduced the rate at which participants needed hospitalization or a lengthy emergency department visit. 

The medication was even more successful if given within three days of symptoms starting, or to unvaccinated individuals.

The rate of side effects was similar between patients who received the interferon or a placebo, indicating it’s a safe treatment.

New COVID treatment options are sorely needed. Paxlovid is currently underutilized. Antibody treatments are no longer authorized because they aren’t a good match for currently circulating strains.

And some experts are worried that molnupiravir, already a less-used option, is causing the coronavirus to mutate in dangerous ways, reports Ewen Callaway at Nature.

But interferon lambda faces regulatory hurdles, executives from manufacturer Eiger Pharmaceuticals told Mueller. The trial was conducted outside the United States, where the FDA prefers to see results originate. 

The FDA told Eiger late last year that it was not ready to grant lambda interferon emergency authorization. The company may pursue authorization in other nations, such as China, Mueller reports.

The interferon lambda data, which have been available for almost a year, “look quite promising,” Dr. Paul Sax of Brigham and Women’s Hospital told Karen Weintraub at USA Today. “It’s been a frustration of mine that it has not been available.”

China study claims no new variants from nation’s outbreak

The recent COVID outbreak in China has not spawned a dangerous new variant as feared — according to a small analysis limited to cases in Beijing, anyway.

“The world should completely calm down from the fear that there are new variants or special variants circulating” in China, researcher George Gao of the Chinese Academy of Sciences told Farah Master and Jennifer Rigby at Reuters.

Gao and colleagues analyzed 413 COVID cases between Nov. 14 and Dec. 20, 2022, and concluded all were probably due to existing strains, mostly omicron BA.5.2 and BF.7. 

China began to roll back COVID restrictions midway through that study period, on Dec. 7.

The result of China’s policy turnabout appears to be widespread infections and death. BBC’s Stephen McDonnell reports that coffins are selling out after an estimated 80% of the population has been infected.

The study’s authors noted they could only provide a “snapshot” of COVID in the nation. The only studied cases in Beijing, and did not investigate ones from the rural areas McDonnell reported on.

“It is important we continue to monitor the situation closely so that any new variants that might emerge are found as early as possible,” Gao said in a statement.

Meanwhile, another omicron subvariant, CH.1.1, is on the rise in the U.K. and New Zealand, reports Jennifer Henderson of MedPage Today

It has a mutation that previously appeared in the delta variant, which was linked to serious disease, and in the contagious omicron BA.4 and BA.5 variants.

Researchers report in a preprint that CH.1.1 emerged in Southeast Asia in November 2022, and may be better able to evade vaccines than previous variants.

California drops plan to require COVID vaccines in schools

California’s plan to mandate COVID vaccination in schools, announced in 2021 and delayed last spring, is now off the table, reports Adam Beam at AP News

Lobbyist Kevin Gordon said the decision probably has more to do with the waning pandemic than political pressure.

The decision matters because California’s actions often influence the nation’s pandemic policies, notes Beam. 

The state was the first to issue a stay-at-home order in 2020. But few states followed California’s lead on the school vaccine mandate. 

The District of Columbia will require the vaccine for schoolchildren come fall.

Officials noted it would be difficult to continually check kids for up-to-date COVID vaccinations, reports Diana Lambert at EdSource.

“I don’t even know what fully vaccinated is … Is it one shot, two shots, three shots?” said Superintendent Peter Livingston of Lucerne Valley Unified in Southern California. “There is no way we could enforce it.”

The other 10 vaccinations required in schools have defined series of one to five shots, without annual boosters.

Vaccine regulations are falling across the nation. The U.S. House has passed legislation that would eliminate the vaccination requirement for incoming foreign travelers, reports Nathaniel Weixel at The Hill.

New York City is ending its vaccine mandate for city workers, and the Los Angeles City Council has backed a plan to eliminate COVID testing of unvaccinated city employees.

What we’re reading

  • “Thousands of kids are missing from school. Where did they go?” by Bianca Vázquez Toness and Sharon Lurye, AP News

  • “A secret weapon in preventing the next pandemic: Fruit bats,” by Jim Robbins, Kaiser Health News

  • “Who’s most likely to save us from the next pandemic? The answer may surprise you,” by Nurith Aizenman, NPR

  • “While COVID raged, another deadly threat was on the rise in hospitals,” by Emily Alpert Reyes, Los Angeles Times

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