One Flu Over The Cuckoo's Nest

Don't panic. Listen.

We were lied to, again.

A recent news story confirms what many of us suspected about bird flu in cows, that mortality rates run between 10 and 15 percent, not the 1-2 percent that dairy farmers were told to expect. They’re “shocked.” The disease is infecting far more cows than originally announced, with 50-60 percent of infected herds showing symptoms. Beyond the high mortality rate, an undisclosed number are failing to recover. They’re being “removed,” a euphemism for culling. One veterinarian said, “his firsthand observations have really challenged his notions about the disease, which has so often been described as mild and insignificant.”

This new outbreak of bird flu on 56 dairy farms in California, on top of growing numbers of human cases elsewhere, indicates that it’s not going away or dying out like government agencies have promised.

It’s getting worse, and it’s learning how to infect humans.

Yesterday, I was thinking about Ken Kesey’s novel One Flew Over The Cuckoo’s Nest, a novel that helped bring about the end of inhumane treatments in mental health facilities across the west. The book highlighted how psychology and psychiatry can become tools misused by institutions to enforce conformity while portraying critical thinking and dissent as mental illness.

I used to teach that novel.

It was a hard sell.

Deep down, my students and I never thought we’d see the return of such massive pressure to look and act normal, especially not at a time that demanded an unflinching look at reality.

And yet, here we are.

As this virus continues to make headlines, the public is left wondering what’s going to happen, whether it will become airborne, whether it’s safe to consume meat or dairy products, and what they should do to prepare. They’re not getting clear answers. Whether it’s bird flu or another threat like toxic gas plumes over Atlanta, our institutions are enforcing conformity and treating those of us who exercise a little critical thinking as if we’re mentally ill.

Here’s the truth:

What is the U.S. doing to prepare?

The answer to that question is nothing.

While Finland rolls out bird flu vaccines to its vulnerable populations, the U.S. has taken virtually zero actions to prepare, and nothing to respond to the rampant spread on dairy farms. Earlier this year, the USDA announced plans to "identify infected herds and wait for the virus to die out." The U.S. government has secured a relatively small amount of vaccine, not nearly enough.

A recent piece in Politico reveals how little our governments are doing to track or control the bird flu outbreaks. According to them, "the federal response is largely focusing on voluntary efforts by farmers," and "testing has covered a mere fraction of the nation's nine million dairy cattle."

Most farms haven't agreed to participate in surveillance.

Nobody is making them.

Scott Hensley, a microbiologist at the University of Pennsylvania, describes what's happening as "a pandemic unfolding in slow motion." Scores of scientists around the world have expressed everything from deep concern to contempt for how the U.S. has been handling bird flu. Collectively, we're repeating every single mistake we made last time. This time, it's worse. Bird flu has been marching relentlessly through the animal kingdom for years, and it's been near the top of almost every virologist's and epidemiologist's list of likely pandemics.

From Reuters:

Federal surveillance of U.S. dairy cows is currently limited to testing herds before they cross state lines. State testing efforts are inconsistent, while testing of people exposed to sick cattle is scant...

Seth Berkley, a widely respected epidemiologist, told Stat News that it's "shocking to watch the ineptitude" of how public officials in the U.S. are handling the situation. If anything, American politicians appear to be courting a bird flu pandemic. Delaware is currently legalizing the sale of raw milk.

Yes, Democrats voted for it.

Can you get sick from dairy products?

Yes, you can get sick from drinking raw milk.

Pasteurization works for now.

Studies have found that cats and mice can both catch bird flu from raw milk. A recent study in Emerging Infectious Diseases found that infected milk killed several cats, leading the authors to conclude that raw milk "might potentially transmit infection to other mammals via unpasteurized milk." Another recent study in the New England Journal of Medicine found that not only does raw milk infect mice, but it remains infectious for up to five weeks when it's refrigerated.

If you’re concerned about cheese, you can buy hard cheeses like sharp and extra sharp cheddar aged for a year or longer.

You can also find plant-based cheeses and sour cream.

(They taste just fine.)

Public health officials and major media outlets have ensured everyone that meat and dairy products remain safe, but they're just guessing. One recent study suggests that the normal pasteurization process isn't always enough to kill the virus, and that we should be upping our standards.

The USDA refuses.

According to Alexander Tin's notes from a conference call with public health agencies, officials don't want to raise the standards of pasteurization for milk because it could hurt the flavor. They also don’t want to test more. The principal deputy director of the CDC (Nirav Shah), said they have plenty of testing capacity for bird flu, but they're not using it because they're worried about "happening just to pick up a stray amount of virus from their nasal passage..."

For the record, infections begin in your nasal passage.

So, that’s your risk from dairy products.

Can you get sick from meat?

Yes, you can.

That's why we have publications like The Journal of Food Protection, dedicated entirely to protecting our food from dangerous diseases. Very recently, they published a study explaining that if you're going to insist on eating chicken, eggs, and beef, make sure you cook them thoroughly to an internal temperature of 71.1C (160F). Don't eat them raw or even rare. Also, fun fact: About 10 percent of American beef products come from culled dairy cows.

Other mammals can get sick from eating infected meat. We know for a fact that bears, foxes, seals, sea lions, and dogs have gotten sick and died from bird flu by eating dead birds. As experts tell us about these infections, "we see carnivores...particularly those that are known to scavenge."

The H5N1 virus doesn't care if you're a fox or a human.

How long can bird flu last in meat?

Generally, it can last for weeks.

A 2021 study in The Lancet found that the H7N9 strain of highly pathogenic bird flu can survive in raw poultry for up to nine days at -20C degrees and up to four days at 25C degrees. The H5N1 strain of bird flu lasts much longer. A 2017 study in Applied and Environmental Microbiology found that "tissue type could strongly affect viral survival." H5N1 can survive in muscle tissue (meat) for 100 to 160 days at 4C degrees and 8-14 days at 20C degrees. The virus can survive longer in feathers, up to 240 days at 4C degrees. The authors review previous studies that found H7N1 virus can survive for 135 days in meat at 4C degrees. Other studies of similar viruses found survival lengths of 40-81 days in poultry meat at 0C degrees, 11 to 14 days at 10C degrees, and 2-3 days at 20C degrees.

So we have a good sense that H5N1 lasts for months in the refrigerator, and probably even longer in the freezer. That's not great news for meat lovers, and it puts extra pressure on them to cook their meat properly.

Or maybe just give it up.

Is bird flu airborne?

We're seeing the early signs of airborne respiratory spread.

A study in the Journal of General Virology found that H5N1 can now replicate in "bovine airway epithelial cells." The researchers documented "rapid increases in viral genome loads and infectious virus during the first 24 hours post-inoculation." Their discussion confirms that the more practice this virus gets at infecting mammals, the better it gets at replicating and shedding in respiratory tracts and airways. Another study in Nature found that H5N1 has started mutating to infect human airways. So, it’s learning to jump from cows to humans.

Why is all this taking so long?

One little gene called BTN3A3 protects the upper and lower respiratory tracts of humans from infection. Researchers at the University of Glasgow Center for Virus Research discovered it last year and published their findings in Nature. The lead author did an interview with Reuters, where he said, "About 50 percent of H5N1 strains circulating globally so far in 2023 are resistant to BTN3A3." Once the virus overcomes that barrier, human cases will go up.

Most of the corporate media coverage has emphasized how "mild" the infections are, but they’re wrong. They describe eye bleeds as “pink eye,” and they’ve downplayed the fact that cases of bird flu have been resulting in hospitalization. Furthermore, as history shows, the 1918 bird flu began as a mild infection and then evolved to become more contagious and deadly.

What symptoms should you look for?

Look for neurological symptoms, not just cold symptoms.

In 1918, doctors misdiagnosed the flu as a dozen other major diseases. It caused severe organ and brain damage. We think of the flu as a respiratory virus. It’s not. It’s a multi-system infection that does lasting damage.

An article in Science News reviews the research on H5N1 outbreaks in wildlife, including the lesions they're finding in the lungs, hearts, livers, kidneys and brains of infected animals. It's causing seizures and paralysis, just like H1N1 did in 1918. This family of viruses "is exceptionally good at making copies of itself inside a variety of cells, including nerve cells." Lucky us, our brains are "covered in birdlike sialic acid proteins." Similar cells line our nasal passages, creating "a direct entry route to the brain from your nose." You could say we're bird brains.

So we shouldn't just be looking for respiratory symptoms or pink eye. We should also be watching out for neurological signs like disorientation, paralysis, lack of coordination, uncontrolled shaking, and tremors.

It will happen.

How long does H5N1 last on surfaces?

One disturbing study from 2010 in Environmental Science & Technology found that H5N1 can last for two weeks on glass and steel surfaces at temperatures around 39F (3.9C), and up to two months under even cooler temperatures. A 2022 study in Emerging Infectious Diseases found that H5N1 can last longer than most other flu viruses, up 24-26 hours on plastic surfaces and 3-4.5 hours on human skin. Fortunately, disinfectants with 40 percent alcohol solution killed H5N1 and other flu viruses within 15 seconds.

Studies on other viruses have shown that flu and coronaviruses can last several days or up to several weeks. They last longer on hard surfaces like plastic, glass, and steel than porous surfaces like cardboard.

Some people want to know if it's time to start wiping down groceries again. Well, that doesn't sound weird to me. If you want to make a UVC decontamination box to make life easier, this 2020 article in the Journal of Medical Systems explains how. You can also make disinfectants with alcohol or hypochlorous acid to help with surface transmission. You can read more here and here. You can also find various online stores that sell HOCl generators.

Should you wear a mask?

Yes, masks work.

Aaron Collins can help you up your mask game.

Despite widely misinterpreted studies about their effectiveness, overwhelming evidence indicates that an N95 mask works when you wear it properly. You have to keep it on. You can’t take it down to eat or drink in public. You can’t take it down to say hello to someone. You can’t take it down because you think you’re alone. Virus particles remain in the air for hours. That’s why we need clean air, and why we need cities and counties to stop passing mask bans. These efforts actively undermine everyone’s efforts to keep each other safe.

Our governments should be encouraging masks.

Not outlawing them.

What happens if you get sick?

If you get sick, and you can’t get proper medical attention, there’s a chance that you’ll be dealing with it on your own. It wouldn’t be a bad idea to dig into plant-based treatments, find something that suits your needs, and have some on hand for yourself and the ones you care about.

Here’s a list.

Should you panic?

It’s fine to feel fear. Fear drives appropriate action. In this case, appropriate action means masks, vaccines, treatments, and clean air. We live in an age of increased threats from a range of viruses, not to mention wildfires and pollution. Unfortunately, our government has taken money from public health and wasted it on police and military spending while convincing the public to “remain calm.”

That’s the situation.

What’s going to happen next?

According to John Barry’s history of the 1918 pandemic, the government did absolutely nothing to prepare for the flu, even as a first “mild” wave circulated the globe and sent up warning signals. Virtually no politician said a word. Newspapers who dared to report the truth were threatened with prosecution. The U.S. was entirely focused on war as death swept over cities. Public health agencies told the public to wash their hands and chew their food properly.

The truth spilled out, after it was too late.

In 1976, the Ford administration earned an enduring badge of shame for taking a rare, proactive approach to prevent a swine flu pandemic. It was one of the most successful public health campaigns in history, and it resulted in very few hospitalizations and deaths. The public came to see the preparations as a waste of time. This misperception fueled a tragic level of indifference to HIV in the 1980s, since no politician wanted to risk humiliation by mounting a response. While the public ignored HIV, the government obsessed over cold war politics and war, and Americans fixated on the imaginary threat of satanic cults infiltrating towns and suburbs. They indulged a moral panic over board games.

There's one exception to the current ineptitude, and that's Michigan. They're actually trying hard to track and contain the virus. If the rest of the country followed their example, we'd be in better shape.

Since most of our governments won't do anything, we have to protect ourselves and each other. That means the usual, masks and clean air. This time, we also have to start paying attention to fomites again. And given that bird flu has a propensity for airborne spread, and our eyes have bird flu receptors, we should be talking about whether we need goggles as well.

Since 2020, H5N1 has led to the death of 50-60 million birds and counting. It's an ecological disaster, unparalleled in scale. Our politicians campaign on the promise of listening to science. Then they don't. On the other hand, you now have most of the information you need.

Use it.

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