Protecting against bird flu

With memories of COVID-19 all too fresh, it’s jarring to hear the World Health Organization again using familiar pandemic terms like surveillance, vaccine production and modes of transmission, all in reference to avian flu.

That doesn’t, of course, mean that another pandemic is inevitable, or that it’s time to panic. But it’s certainly time to take precautions and apply the tough lessons learned throughout COVID.

Chief among them is the need for health officials to be transparent and upfront with information.

On this front, the Canadian Food Inspection Agency has sent confusing signals. In late April, after fragments of the avian flu virus were found in American milk, the agency announced that it was not testing Canadian milk because cattle here had not shown clinical signs of infection.

Just a few days later, the agency again reassured us that Canadian retail milk is safe because pasteurization inactivates the virus that causes bird flu. But in a surprise about face, it also announced it would be testing retail milk as part of a package of enhanced surveillance measures, including facilitating the “voluntary” testing of asymptomatic cows.

The enhanced surveillance is certainly welcome since infected cows typically suffer only mild illness and might, therefore, not present with clinical signs of the disease. But the agency’s initial reluctance to test suggests it was more interested in telling us not to worry than ensuring that there’s nothing to worry about.

It’s a playbook American authorities know well. Writing in the New York Times, sociologist Zeynep Tufekci argues that since the COVID-19 pandemic, authorities have focused on “telling the public how to feel — to panic or not to panic — rather than sharing facts and inspiring confidence through transparency and competence.”

Indeed, even after the virus had been detected in dozens of cattle herds in multiple states, the United States Department of Agriculture had no idea how many farmers tested their cattle, nor the number of positive tests. Still, it stopped short of ordering mandatory testing or employing surveillance techniques like wastewater surveillance, which was widely used during the COVID-19 pandemic.

This see-no-evil approach could well contribute to further outbreaks in the United States, and hence American agencies are now taking further precautions. Lax surveillance could also lead to a similar spread of the virus here, creating hazardous conditions for farm workers and increasing the risk of a full-blown pandemic.

Thus far, only one farm worker in northern Texas has tested positive and has experienced only mild symptoms. However, since 2003, more than half of the people infected with avian flu have died. And given the extensive interaction between humans and cows and the rapid transmission among cattle populations, we ought to act now, before people start showing up in the emergency room.

Dr. Tedros Adhanom Ghebreyesus, WHO director-general, said this week that the virus has not shown signs of having adapted to spread among humans but added, “more surveillance is needed.” The WHO currently assesses the risk to the general public as low and low to moderate for people exposed to infected animals.

If we’re to reduce the risk to the public, and especially to farm workers, enhanced surveillance and protective measures are imperative, and they must go beyond merely testing milk and facilitating voluntary testing of cattle.

Since cows don’t necessarily display symptoms, systematic testing is essential. But given the expense of testing and the potential impact of positive tests on farms, the government could offer some funding and support to farmers.

Farm workers, who at present face the greatest risk from an outbreak, should also be subject to random testing, and should be provided with personal protective gear such as face shields.

Finally, wastewater surveillance could also aid in early detection, with one American study, not yet peer-reviewed, confirming the value of wastewater monitoring for diseases that spread from animals to humans.

Given the threat avian flu presents, the Canadian Food Inspection Agency and other public health authorities need to consider all such potentially valuable means of stopping a pandemic before it starts.

WORTH REPEATING

‘That’s going to make our people, our communities, those who participated (in government consultations) feel even more unheard, more unseen, and feel even more like they don’t matter.’

DANIA MAJID, HEAD OF THE ARAB CANADIAN LAWYERS ASSOCIATION