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We’ve been reporting on the growing outbreak of H5N1 bird flu across the US and the world for many months now, and while we don’t want to fearmonger, we think it’s important to keep an eye on what’s keeping epidemiologists up at night. Unfortunately, that’s bird flu. It’s in the news for driving egg prices up after ravaging poultry farms - 58 million chickens have died or been culled because of the current outbreak. It’s spreading rapidly, not just in domesticated farm animals but wild flocks, fueling more spillover into mammals. Foxes, raccoons, skunks, and bears (and even seals and dolphins) have been infected, likely from eating infected birds. A mink farm in Spain saw a massive outbreak of H5N1 last fall, confirming that mammal-to-mammal transmission is possible. This has led some public health experts to call for an end to mink farms, as they’re a particularly good cross-species vector for viral mutation. Still, in this outbreak, no minks or other mammals have spread the virus to humans, and there hasn’t been any evidence of human-to-human transmission. We’re keeping a close eye on it - while a bird flu pandemic is far from inevitable, it’s a real possibility that we need to be prepared for.
The FDA has announced a major recall by a Baltimore prepared foods company that supplies items to Amtrak and other businesses across the East Coast. While no one has gotten sick from these recalled foods yet, over 250 people die each year from Listeriosis. It’s particularly dangerous for pregnant women and their babies, those 65+ and immunocompromised people. Keep an eye on the most susceptible foods, like sprouts, soft cheese and other unpasteurized milk products, cold cuts and fermented or dry sausages, melons, and refrigerated smoked seafood. When products are recalled, be sure to throw them away even if some of it has been eaten and nobody has gotten sick. Wash and sanitize any areas that the product may have contacted, including prep and storage areas. As always, employees with diarrhea and/or other flu-like symptoms should stay home while sick.
Vaccines, including the updated bivalent booster, will continue to be available for free until the government stockpile runs out. After that, the vaccine will be covered by both private insurance and Medicare and Medicaid. If you’re uninsured, it’s unclear how you’ll access vaccines, though officials have said there will be some way to get cheap or free COVID vaccines moving forward, according to Katelyn Jetelina from Your Local Epidemiologist. If you don’t have the latest bivalent booster, go get that ASAP. If you already got one and are considering whether to get a second (which isn’t currently a recommendation by the CDC), this is an ongoing debate among public health officials, and is expected to be discussed in the upcoming ACIP meeting in two weeks. They may make a recommendation around whether higher-risk people need another booster before the fall.
For this winter, the worst of it is most likely over. It’s a bit hard to tell definitively. When flu and RSV surged so early, there were lots of ways this winter could have gone, and we’re all glad to say that it’s looking like the worst of this winter is behind us. There’s a lot we still don’t understand about the seasonality of COVID. Mara Aspinal from Arizona State summarized the current state earlier this week she wrote “Although we may be entering the endemic phase, it is otherwise known as the ‘we are stuck with this forever’ phase.”
The “immunity wall” that we’ve built from past infections, vaccinations and boosters is helping. COVID isn’t over, as much as we wish it was. There are still 400 people each day dying in the US, far more than die of the flu. We’re not out of the woods yet - and a new variant mutation could happen anytime (may already be happening) and spike cases again. But barring that, we’re hopeful that this downward trend continues for this winter.
We return to our old friend Dr. Michael Osterholm's podcast as a best listen today since many of you have raised concerns about the potential impact and costs of long COVID. Give a listen here:
Taking Long COVID Seriously | CIDRAP: Osterholm Update COVID-19