Mike DiGirolamo (narration): Welcome to the Mongabay Newscast. I’m your cohost Mike DiGirolamo. Bringing you weekly conversations with experts, authors, scientists, and activists working on the front lines of conservation whining a light on some of the most pressing issues facing our planet and holding people in power to account. This podcast is edited on Gadigal land. Today’s guest on the newscast is Apoorva Mandavilli. A science and global health reporter with the New York times. She joins me today to talk about the current outbreak of H5N1, otherwise known as avian influenza, or bird flu. It has infected over 500 bird and mammal species worldwide killing certain populations of species on six separate continents by the thousands in what is referred to as a ‘panzootic.’ Experts have described this as an existential threat to the world’s biodiversity. Mongabay contributor Sharon Guynup wrote the story for us that was published on August 6. The number of confirmed human cases in the current clade is still relatively low, but experts are worried about how the virus could mutate from here. Mandavilli talks about those concerns. She also discusses the context of how our industrial agriculture system helps create the conditions for outbreaks like this to occur and how the degradation of our natural world influences the frequency of global pandemics. She discusses the human health risks we face, what we know, and what experts still don’t know.

Mike: Hi, Apoorva. Thank you for joining us.

Apoorva Mandavilli: My pleasure. Thanks for having me.

Mike: So, you’re here to talk to us today about the current outbreak of H5N1. And there’s a lot of information to go over here, but first, can you summarize for us when this current outbreak began and when it started to really ring alarm bells for epidemiologists?

Apoorva: The first time we heard about this particular virus showing up in dairy cattle in the United States was in March. Although we now know that it probably started earlier than that. And at first, it seemed like a few isolated cases, but then we started to hear about more and more herds being infected, and it very quickly became clear that this was a much bigger problem, and that there were probably dairy herds infected all over the country, at least in multiple states. And that has proven to be the case.

Mike: So, this is something that’s referred to as a panzootic and it has infected over 500 bird and mammal species worldwide. So, have we seen a situation like this before, or are we in uncharted territory?

Apoorva: We are in a bit of uncharted territory. I mean, the virus has been around for a long time, and since the late 1990s, we’ve seen sporadic cases in outbreaks in poultry, cases in people, we’ve seen deaths in people. But what’s happened over the last couple of years is this really amassing of mammalian hosts. The virus seems to have adapted itself to dozens and dozens of new host species. And that’s really what has a lot of virologists that I speak to worried, because they’ve never seen a virus acquire. So many new hosts in such a short time period and it looks like maybe the virus is evolving and changing, but we don’t have a very good view of exactly how it’s changing and what it’s doing to the animal species that it’s infecting.

Mike: Right, yeah, it’s killed 10, 000 black-browed albatross in the Falklands, and 17, 000 elephant seal pups in South America infecting wildlife on six continents, with the exception being Australia. So, research does show it can spread directly between mammals. So, experts are saying this presents an existential threat to the world’s biodiversity. So, what are your thoughts on this and this type of evolution?

Apoorva: So, there are a few different opinions about this. You mentioned the elephant seals in South America, and that definitely was, by all signs, a case of mammalian transmission. However, I have talked to experts who say, well, you know, those aren’t really like people and we’re unlikely to see that same kind of transmission in people just because it’s happened there. In these sea mammals. On the other hand, everybody agrees that every new case is an opportunity for the virus to evolve. Every new species is an opportunity for the virus to acquire new abilities. And so, the more we let this virus run wild, the more this virus, the outbreak continues and continues to infect new species. We are really giving this virus enormous opportunities to become adapted and possibly become very good at spreading among people.

Mike: And on that note, so the, the first case of it jumping from birds to mammals, I believe was about two years ago

Mike (narration): This is incorrect. I misstated this and it meant to refer to the current outbreak. Apoorva will clarify here further. It is the current clade of the virus.,

Mike: but when did we start seeing it transmit to humans?

Apoorva: Well, we didn’t first see it transmit from birds to humans two years ago. We’ve seen it transmit from birds to humans for a few decades now mostly in Asia. And what’s different in the last couple of years is that there is a particular clade, this sort of family of viruses of within H5N1 that have shown up in Europe and North America, and those are somewhat distinct from the ones we’ve been seeing in Asia. And so that’s…the cases that we’ve been seeing where it’s been jumping into mammals, the first that you hear about is really specific to that particular clade of H5N1.

Mike (narration): And that clade is dubbed 2.3.4.4b

Apoorva: And so yeah, we have been seeing more and more of that. The virus was really everywhere in waterfowl. last year and the year before that. And so, when you have so much virus in the environment, you have so much virus in wild birds, it seems almost inevitable that at some point it’s going to jump into at least some species, you know, poultry, chickens are just really susceptible to these kinds of viruses. So that’s not a huge surprise. But when you see it show up in something like dairy cattle, that really threw all the virologists I talked to for a loop because, there are some instances in the literature of dairy cattle becoming infected with influenza, but really for the most part it was supposed to be just influenza D, which is one subtype of flu, whereas H5N1 is influenza A, and nobody had really thought about that showing up in cattle before. So, it’s, it’s been a series of surprises for virologists.

Mike: And so, when did we start seeing this current clade start to transmit to humans?

Apoorva: So, the first case we saw in this particular outbreak really was in March and April of this year. We, Texas was the first to announce a case and then we saw a couple in Michigan which actually I think that that particular state has been pretty good about trying to figure out cases. And then we saw a whole bunch in Colorado, which has been very, very aggressive, very proactive in trying to find cases. So now we’re at 13 human cases. Which, you know, we had only seen one other case before in 2022, so that’s a lot of human cases to see in North America, which we hadn’t really seen that before.

Mike: So, David Wallace-Wells mentioned in his opinion piece that, there’s nothing like a serious plan to properly monitor the spread. So what does, the plan, so to speak, look like and what’s leaving us unprepared to properly monitor it?

Apoorva: So let me start off by giving them some, some wiggle room here, which is that the way that the U. S. is structured with so much of the power being held by the states makes it very difficult for any kind of plan. The federal government actually has pretty limited power to go into states and do things unless the states invite them to do so. So, for example, the CDC can’t decide that it’s going to test farmers. That’s up to the state government. They have to invite the CDC to come in and do that. And that’s true for other federal functions as well. There are some states that have been, as I said, aggressive, like Colorado, who have decided, Okay, this is important, we’re going to do this. They’ve been working with the CDC. But there are many other states, like Texas, for example, where we don’t really see much of a plan, and it’s probably not all that surprising because they do rely very much on the dairy industry there. The cattle industry is huge. And, you know, so every state is sort of doing things in its own way and farmers and farm owners and farm workers, because they’re not being compelled to do any testing, are not really volunteering because what incentive do they have to do that?

They have everything to lose and nothing to gain by being open about the infections that they have. You know, they’re not seeing cattle die by the dozens. They are not seeing people die really at all. And so from their perspective, this seems like a virus that is causing some temporary disruptions to their farms. But if they were to be open about it and tell the government about it, that could really result in some severe restrictions on their herds. Maybe bad publicity, definitely economic impact. And so they really have no incentive to come forward. And so that’s what we’re seeing play out. And from the people that I have talked to, you know, generally, they’ve been saying that with both within the states and outside, the experts I’ve talked to say that the CDC has actually been doing relatively well this time doing whatever they can, given their, the limitations that I pointed out, but that they would really like to see the animal sector do more.

And that means the USDA. So, you know, the U.S. Department of Agriculture, which is in a very tricky spot, that particular department of agriculture, they are tasked with both regulating, and promoting the agriculture industry. And so that makes it very difficult for them to be hard-nosed and say, you must do X, Y, Z because they run the risk of losing trust. They run the risk of being able to work well with these producers. And so they’re trying to, I think, walk the line. And I’m not sure they’re doing such a good job of it. And certainly, the experts I talked to are all very frustrated.

Mike: So, the Center for Disease Control in the United States says on its website, as of August 13th, that the current public health risk is low. But they’re watching the situation carefully and working with states to monitor. So, what does a, a low risk mean here and what is currently the most worrying public health risk in the United States?

Apoorva: I mean, sure, yes, I think, very broadly speaking, the public health risk is low in that we haven’t yet seen large numbers of cases, we haven’t really yet seen any signs that the virus has adapted to spreading between people. Having said that, all of that could change on a dime. The virus could acquire new mutations tonight, next week, next month. We don’t really know when that switch might be flipped. And so, we’re taking a little bit of a chance here, I think, waiting to find out what might happen and not having a clearer plan. So, for example, I think we need rapid tests. That are out there closer to the people who need them. So, farmers, because they’re not coming out to the clinics to get tested. We’re not really going to know if they’re positive. But if they have tests they can do in the privacy of their home, where maybe their employers won’t know about it, and they don’t have to tell anybody, but they will at least know an answer. And then they could go to a clinician and get some help. You know, the easier you make it for people to test themselves, the more likely that they will do it.

And so, we haven’t really seen that kind of availability of testing. So that’s one thing. We’re not really ready in terms of the vaccines, you know, we have a few and they’re making a few more, but it’s really a drop in the bucket when you think about the kind of need that we will have if this were to really become an epidemic in the States. And we don’t really have great antiviral drugs. You know, we have some, the one that everybody always talks about is Tamiflu. We have a lot of that, but there are some signs that the flu virus has been adapting, you know, mutating against Tamiflu. And there are other antivirals that we could rely on in that case, but we just have very, very few doses of those drugs. The bulk of what we have is Tamiflu. And so if the virus ends up being resistant to Tamiflu, then we don’t have great options.

Mike: On that note of, transmitting humans, it’s referred to as a highly pathogenic avian influenza, HPAI in that it jumps from birds to mammals and livestock with frightening agility as our contributor Sharon Gynup wrote in her recent piece. So, given that, could we expect that same agility in its transmission between humans, if it becomes so.

Apoorva: You know, it’s really, really hard to say. I think that this is sort of, we’re, we’re walking into really unknown territory there. If the virus were to adapt to spreading between people, it would have to get better at binding human receptors. At the moment, it binds well to receptors deeper in the respiratory system, but if it becomes better at transmitting because it’s now binding in the nose and throat, it might not be so good at binding deeper in the lungs, and that might mean that it’s just not as severe.

So, we don’t know if the mutations that it acquires means it’ll transmit better, but it won’t be as severe. We also, I think, are making some assumptions about what the mortality might or might not look like. You know, there’s a lot of talk in the U. S. about how it’s been really mild so far. Well, that might be a function of the mode of transmission because we’ve been seeing pretty much I think cases that have been transmitted from milk of the dairy cattle and in some cases by interaction with poultry, but you know, we don’t have enough numbers to be able to confidently say that if the virus were to jump into people, the mortality would be very low and it would be very mild. The other clade that I’ve mentioned in Asia has had a mortality of close to 50%. So it could be that bad, or it could be not at all severe as we’ve seen so far in these few cases that we’ve seen, and it could be anywhere in between. So, it really, we don’t know very much at this point of about exactly what it’s going to look like and how easily it’ll jump or how severe it’ll be.

Mike: Yeah. I was going to ask you about that. Michael Mina told David Wallace Wells and Wallace Wells wrote in his opinion that a true infection fatality rate in the low single digits could be expected. Which is uh, it’s quite disheartening to hear and just. That’s, that’s a lot. So I was going to ask you if you had any comment on that or why such a high number.

Apoorva: Well, I don’t know exactly what Michael Minna is basing it on. You know, I’ve talked to him a bunch of times over the last few years. He’s a very smart man, but I don’t know what he’s basing that on. The um, some of the other biologists I’ve talked to have said, really, again, as I was just saying, we don’t know. I think because we have not seen this particular clade of the virus transmitting in people, it’s really pretty much impossible to predict exactly what it will do. It’s changing. The virus is changing, and that means as it acquires mutations, it may go in any direction. You know, unlike the myths out there that say that the virus as it evolves becomes more and more mild, evolution is random. So, we don’t know what mutations it’ll end up acquiring. And I think the single digits maybe is coming from extrapolating from what we’ve seen elsewhere in the world and that even if it’s a fraction of that it would still be single digits, I’m not sure. It could be. It could very well be that. Or it could be that it ends up being like a bad cold. We just don’t know.

Mike: I think it’s worth pointing out real quick that Vincent Munster from the virus ecology section at the U. S. National Institute of Allergy and Infectious Diseases says the virus is a direct result of commercial large scale poultry farming. Can you comment on this and talk about how and why?

Apoorva: I think this whole outbreak has really put a spotlight on that. I don’t know if it’s a big enough spotlight for us to do anything about it, but certainly I think there are a lot of people who have become more aware. That the way that we do agriculture, the way that we do, you know, livestock rearing in this country, you know, the poultry farms, the, the cattle farms, the pig farms, animals are just grown in very, very tight quarters. And so, when you have, you know, one cow infected, it’s much easier for other cows to get infected. I’ve spoken with some um, farmers in places like Kansas over the course of reporting on this outbreak over the last few months. And, you know, I’ve heard them talk about how most farms used to be really small, you know, 100 cows to 150 cows.

And now you’re talking about dairy farms that have thousands of cows. It’s really been replaced by the sort of very factory set up. And so, we’re really creating in some ways very good conditions for viruses to get through very quickly. And the thing that a lot of people I talk to really worry about are pig farms, because pigs are fantastic hosts for flu viruses, and if a pig had two different flu viruses infecting it at the same time, those two viruses could swap ingredients. For example, you could see one that had the severity of H5N1 the way it is in Asia, but with the transmissibility of seasonal flu it’s, it’s just, it just opens the door to all kinds of possibilities. And so, when we are not paying attention to how we’re doing farming in this country and how we’re growing animals in these massive numbers. I think we’re really running the risk of having more zoonotic outbreaks like this.

Mike: Something else Wallace Wells pointed out in his opinion is that 15 nations in the European Union are already proactively vaccinating dairy and poultry workers, but the United States is not. So why isn’t the U. S. doing that? What’s, the strategy there?

Apoorva: Well, that’s a very good question. I think they, you know, that the official answers are always about worries about commercial viability. That there will be countries that won’t want to import meat from the U.S. poultry, you know, products from the U.S. If the birds are vaccinated. Or the cattle are vaccinated. However, you know, I’ve talked to experts have said, well, would you rather have virus in that meat? So, I think there is no good solution there. Most experts I’ve talked to have said it is too premature to talk about vaccinating workers. Cattle workers, you know, poultry workers, just because the vaccine that we do have is not proven to be all that good. And, you know, we don’t really know if it’ll work. We don’t have that many doses. It just doesn’t seem like we’re quite there. But in terms of vaccinating cattle, very mixed opinions on that. I’ve heard some scientists who’ve said, well, you know, it’s flu viruses are generally not that great at preventing infections.

So, what exactly is the point here? We haven’t really seen great severity and illness. Why are we vaccinating with something that might not actually be all that effective or useful? But then I’ve also had, you know, experts say, well, we should really be doing this. We should have been, we should have started doing this yesterday. And I know I’ve talked to some companies who are very interested in developing vaccines, but progress on that front just seems to be extremely slow.

Mike: So, you mentioned the sort of difficulty in getting like large scale testing done but it also seems that, you know, protective equipment like masks are also not being given to livestock workers and it seems quite worrying you know, given everything we’ve learned from pandemic. So, what’s your opinion on this? Are there more lessons to be learned from the pandemic that we’re actually currently still in? Are there lessons there that we should be taking away and applying here?

Apoorva: To be honest with you, the lesson that I learned from covering the pandemic is that you can’t make people do what they don’t want to do. And I think that’s what’s playing out here. I mean, there might be some element of shortage of personal gear, like masks and goggles and so on. But a lot of this actually comes down to farmers not wanting to wear it, especially this summer. It’s been incredibly hot here. And Colorado has very openly said, you know, in their, in their outbreak where they’ve seen nine cases, 10 cases that the, a lot of the cases were in farmers farm workers who were involved in depopulating the poultry, you know, culling the poultry and they were working in these incredibly hot conditions. They had fans blowing so you can just imagine, you know, feathers blowing in those kinds of conditions, first of all, nobody wants to wear a mask because it’s already sticky and unbearable. But even if they did wear one, it’s not really clear that it would be useful because you wouldn’t get a good enough seal if they were sweating and so on. So, I think it’s, it’s really a question of how willing people are to wear it, how able they are to wear it rather than simply the availability.

Mike: Nationally speaking there’s been some criticism from some experts at how the United States is responding. Is it fair to say that the United States is meeting the current situation with indifference? And if so, what could they be what could the United States government be doing differently?

Apoorva: I’m not sure I’d characterize what they’re doing as indifference. You know, they do hold these weekly meetings. They answer reporters questions. I’ve sent them, you know, thrown questions at them, and they do come back with responses. They are, I think, trying. And as I mentioned, I think the CDC is doing okay, according to the experts I talked to. I think it’s more on USDA. I’m not sure they’re really used to this level of scrutiny, this level of attention, but also this level of involvement in an outbreak like this. And I think they’re just not really used to giving information or planning for it. So, I wouldn’t say indifference so much as a lack of planning, perhaps, and definitely, at times, it seems like the responses they give just don’t jibe with what you’re hearing from other experts. So, for example, in these calls that I just mentioned that they have with reporters just about once a week, even in the last couple of weeks, they’ve said they’re very confident that this virus can be contained, that this outbreak can be contained, they’re not really worried, they think it’s, you know, all under control. And that is not what I’m hearing from other experts at all. So it’s less, I think, indifference and more perhaps an unwillingness to face the real risks here. And that’s the scale of what could be

Mike: So, I want to be sensitive to the fact that, you know, some people may have some pandemic fatigue here from what feels like an endless cycle of health crises that they just seem to be, you know, getting more and more frequent. And now we have an outbreak of mpox in Africa. So, from your perspective as a journalist who covers global health, does it surprise you that we appear to be on the precipice of yet another human pandemic?

Apoorva: It really doesn’t, unfortunately. I mean, I’ve been watching H5N1 for 20 plus years, and it always, to me, seemed like it was on the cusp becoming, you know, turning into a pandemic because it just had so much potential to wreak havoc right from the start. And if you had asked me 10 years ago, I would have bet money on H5N1 being the next pandemic. And so that doesn’t really surprise me. But in general, to see the number of infectious disease outbreaks mpox, as you mentioned, all of these things. Not really. I mean, it doesn’t surprise me because we are living in these incredibly interconnected worlds where you should have a outbreak anywhere and it would be very easy for it to get everywhere else. We are also living in these incredibly crowded conditions, you know, deforestation, climate change, people living in extremely close proximity to animals because of um, deforestation and other things, you know, encroaching on animal habitats. And so having very close contact with these animals and giving opportunities for zoonotic outbreaks, but then also factory farming, as we were mentioning, there are just so many opportunities now for viruses to jump from animals into people. And then once they get into people to spread all over the world quickly because of transportation. And so it’s just, it’s really not surprising, I think. And I’m always really befuddled by the lack of investment in pandemic preparedness and public health preparedness because, of course, people are tired of it, but governments should not be.

Mike: What’s something that you’re looking at right now as the situation develops?

Apoorva: You know, there’s so many things I’m looking at. I’m trying to figure out, you know, what is the government doing in terms of vaccines? Are they, for example, talking about now vaccinating cattle? When do we move to that conversation? When do we move to the conversation about vaccinating dairy workers? What’s happening in terms of testing? You know, they’ve been talking to companies, but when are we going to see rapid tests that people can use in the privacy of their homes? What are we knowing, you know, what are we learning about the genetics of the virus? You know, how quickly are they sharing information and are we able to see how the virus is changing and what do those mutations mean for us? There are just so many unknowns in this outbreak. It’s kind of an evolving situation. Every week there are more and more herds that are infected and so just trying to grasp really the scale of what’s happening. I think the number one biggest question I think everybody has is how big is this thing really? And we don’t really know the answer to that.

Mike: Apoorva, thank you so much for joining me today. I appreciate it.

Apoorva: Thanks very much and thanks for pronouncing my name so well.

Mike (narration): If you want to read the story mentioned in this podcast from Sharon Guynup. Please see the link in the show notes. As always, if you’re enjoying the Mongabay newscast or any of our podcasts content such as our sister series, Mongabay Explores, and you want to help us out, we encourage you to spread the word about the work that we’re doing by telling a friend. Word of mouth is still the best way to help expand our reach, but you can also support us by becoming a monthly sponsor via our Patreon page at patreon.com/Mongabay. We are a nonprofit news outlet. So, even just a dollar per month does make a difference and it helps us offset production costs. So, if you’re a fan of our audio reports from nature’s frontline, go to patreon.com/Mongabay to learn more and support the Mongabay Newscast and all of our podcast content. You and your friends can join the listeners who have downloaded the Mongabay Newscast over half a million times, by subscribing to this podcast, wherever you get your podcasts from, or you can download our app for apple and Android devices. Just search either app store for the Mongabay newscast app to gain fingertip access to new shows and all of our previous episodes. But you can also read our news and inspiration from nature’s frontline at mongabay.com or you can follow us on social media. Find Mongabay on LinkedIn at Mongabay news or on Instagram Threads, Bluesky, Mastodon, Facebook and Tik ToK, where our handle is @Mongabay or on YouTube @MongabayTV. Thank you as always for listening.