The H5N1 outbreak, already a devastating crisis for cattle farmers and their herds, has the potential to turn into an enormous tragedy for the rest of us. But having spent the past two weeks trying to get answers from our nation’s public health authorities, I’m shocked by how little they seem to know about what’s actually going on and how little of what they do know is being shared in a timely manner.

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It’s entirely possible that we’ll get lucky with H5N1 and it will never manage to spread among humans. Spillovers from animals to humans are common, yet pandemics are rare because they require a chain of unlucky events to happen one after the other. But pandemics are a numbers game, and a widespread animal outbreak like this raises the risks. When dangerous novel pathogens emerge among humans, there is only a small window of time in which to stop them before they spiral out of control. Neither our animal farming practices nor our public health tools seem up to the task.

There is some good news: David Boucher, at the federal government’s Administration for Strategic Preparedness and Response, told me that this virus strain is a close match for some vaccines that have already been formulated and that America has the capacity to manufacture and potentially distribute many millions of doses, and fairly quickly, if it takes off in humans. That ability is a little like fire insurance — I’m glad it exists, but by the time it comes into play your house has already burned down.

https://www.nytimes.com/2024/04/24/o...-outbreak.html

All this makes catching potential human cases so urgent. Dr. Bright says that given a situation like this, and the fact that undocumented farmworkers may not have access to health care, the government should be using every sophisticated surveillance technique, including wastewater testing, and reporting the results publicly. That is not happening. The C.D.C. says it is monitoring data from emergency rooms for any signs of an outbreak. By the time enough people are sick enough to be noticed in emergency rooms, it is almost certainly too late to prevent one.

So far, the agency told me, it is aware of only 23 people who have been tested. That tiny number is deeply troubling. (Others may be getting tested through private providers, but if negative, the results do not have to be reported.)