Déjà Vu All Over Again — Refusing to Learn the Lessons of Covid-19

The spread of H5N1 avian influenza among cattle and other farm animals as well as to agricultural workers in the United States has raised concerns about the potential for an influenza pandemic. Although the threat of pandemic H5N1 doesn’t appear to be imminent — this variant has yet to show the potential to be transmitted from human to human — the federal government’s initial response suggests that, rather than heeding the lessons from Covid-19, elected officials and other key decision makers may be relying on a dangerous type of revisionism that could lead to more deaths, should H5N1 cause a pandemic.

The prospect of an H5N1 pandemic has been a source of concern ever since the virus was isolated from humans in Hong Kong in 1997. In response, the U.S. government began developing pandemic-preparedness plans. A series of reports from the Institute of Medicine (now the National Academy of Medicine) and the National Academies of Sciences, Engineering, and Medicine has emphasized the need for the stockpiling of personal protective equipment, resilient supply chains, and greater coordination between agencies and various levels of government.1 Yet despite these plans and warnings, and despite being ranked the most prepared among 195 countries to handle a pandemic on the Global Health Security Index in 2019, when Covid-19 arrived, the United States fared terribly by most measures.2

During the pandemic, well-described weaknesses in the U.S. public health response were often masked by overconfidence, as some elected officials and political appointees continually reassured Americans that the country had “the tools” to respond adequately to this new threat. The types of testing and surveillance problems that marred the response to Covid-19 are now being repeated with H5N1, with recent genetic analyses suggesting that the virus circulated undetected in cattle for months.3 Because of inadequate testing, the actual number of cases among dairy and other agricultural workers is also unknown. As with meatpacking facilities in the early months of the Covid-19 pandemic, the reluctance of dairy-farm employers to cooperate with health officials has hampered widespread testing and surveillance.