Lone Candle
Champion of Truth
“A widespread avian flu outbreak devastated the poultry industry in 2022, causing the deaths of more than 43 million hens. December egg inventories were down nearly 30 percent from the year before, just in time for the holiday baking season. Under the basic rules of economics, a persistent drop in supply leading into a time of increased demand is bound to have this result.”
“The squeeze on eggs is so bad that some grocery stores are reporting shortages, and some are even limiting the number of cartons customers can purchase.
It’s a significant change for what’s long been a reliably cheap staple, and there’s one major culprit: the bird flu.”
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“The last year has brought the worst bird flu outbreak in US history, and there are no signs it’s going to relent soon. Some 57.8 million birds in the US — mostly egg-laying hens — have died as a result of bird flu outbreaks surpassing the previous record of 50.5 million in 2015, and it’s not letting up. Just in the 10 days prior to Christmas, 1.5 million egg-laying hens died.
The virus is expected to continue to circulate among wild birds and the ones we raise for food for the duration of winter, meaning egg prices — along with prices for turkey — could remain high for the foreseeable future.”
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“most victims don’t die from the virus itself. Rather, they’re culled, or proactively killed, in a brutal effort to prevent the virus from doing even more damage.”
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“a major reason why bird flu is so destructive in the US is that factory farms — with so many chickens and turkeys in such close quarters — are the perfect playing field for the virus, which is why farmers are so quick to cull infected flocks. But that very fact raises a simple, but surprisingly controversial question: If avian flu is so deadly and so economically destructive, why on earth aren’t we vaccinating birds against the virus?”
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“For countries in which poultry exports make up a big share of the industry’s revenue — such as the US and many European countries — vaccines have largely been a nonstarter, even though they have the potential to severely limit the death toll of mass culling. Why? Blame the “DIVA” problem.
DIVA is short for “differentiating infected from vaccinated animals” — the challenge of identifying whether a bird is actually infected with avian influenza, or just has avian influenza antibodies after vaccination. Countries fear that importing eggs or slaughtered meat from vaccinated birds in countries where the virus is circulating could inadvertently spread it within their own borders by introducing the virus to wild or domesticated animals through discarded raw meat. That means that big poultry exporters like the US — which sends 18 percent of its poultry abroad — don’t vaccinate, for fear they’ll miss out on a huge part of their revenue: international trade.”
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“without international coordination and predictable vaccine use, it doesn’t make economic sense for vaccine makers to invest in developing vaccines that protect against the bird flu. “We’re not going to make [massive investments] unless we’ve got major markets on board,” said du Marchie Sarvaas. “And the only way you’re going to get major markets on board is if you get some sort of political deal. And that comes to the trade point and the export point.””
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“It’s also a geopolitical coordination challenge, a classic game theory problem where no major poultry-producing country wants to be the first to vaccinate. As a result, everyone sticks with the kill ’em all approach.”
“Some portion of this steep rise in cases is related to the fact that more people are being tested for the flu than in previous years. Over the month of November, about twice as many flu tests were done at clinical labs nationwide as during the same period last year (about 540,000 versus 265,000). More testing means more cases will get picked up.
However, there are corroborating warning signs that this is truly a bad season. Flu hospitalizations have been off the charts and are rising quickly. In a press conference Monday, CDC director Rochelle Walensky said there have already been 78,000 flu hospitalizations this season, or nearly 17 out of every 100,000 Americans. That’s “the highest we’ve seen at this time of year in a decade,” she said. In keeping with past trends, the highest hospitalization rates are among adults 65 and older.
What’s making these high hospitalization rates particularly concerning is their overlap with surges in other viruses causing many people to get sick enough to require admission. One of those is RSV, which has been packing pediatric hospitals for more than six weeks. And while Walensky noted there were signals RSV transmission was slowing in parts of the country, Covid-19 hospitalizations recently began to tick upward.”
“Before the pandemic, the flu alone could sometimes push hospital systems into crisis mode, where they cancel elective procedures and limit other kinds of care. Now there’s Covid-19, which has done the same thing on its own.
Suddenly conjuring more hospital capacity every winter to handle the expected surges of flu and Covid-19 is not going to happen. Thousands of additional hospital beds are not coming in the next few years, and the US would not have the doctors and nurses to staff them anyway. It will take much longer — years or maybe decades — to improve the gaps in America’s health care infrastructure and workforce that have been exposed during Covid-19.
This means the imperative to “flatten the curve,” to limit the spread of these viruses to stop hospitals from being overwhelmed, will be with us for a long time. But the makeup of the curve will change, measuring multiple diseases instead of one.”
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“Vaccination is the best way to stop a bad Covid-and-flu season before it starts.”
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“Surveillance is critical, starting with early-warning systems. Public health institutions have long monitored the flu and they are already tracking Covid-19 in a similar manner. Monitoring the amount of virus detected in local wastewater has proven to be a reliable leading indicator of new Covid-19 waves during the pandemic. And widespread, reliable testing will be essential — including at-home tests for both Covid-19 and the flu.”
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“Frequent testing lets people know that they should isolate. If they are at higher risk of severe illness, they can get on antivirals quickly. The current therapies are most effective at stopping serious symptoms that could require hospitalization if they are taken within the first few days of an illness. Research in the last decade has found that flu antivirals are too often underprescribed for patients who would benefit most; improving prescription rates is only more critical now that the health system will be contending with both the flu and Covid-19 going forward.”
“Although the U.S. continues to struggle with COVID-19, it has apparently beaten the flu into submission. Since the end of September, the combined total of positive flu cases identified by both public health and clinical labs is fewer than 1,500. There are high schools with more people in them. The phenomenon is not only in the United States — worldwide, rates of influenza are nearly off-the-charts low. When you line multiple years up on the same graph, it can even look like there are no cases of flu this year. That’s how out of step we are with the norm.”
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“This massive shift, experts told me, is likely tied to the precautions we’ve taken to avoid catching COVID-19: mask-wearing, social distancing, obsessive cleaning of surfaces (which doesn’t do much to prevent COVID-19 but probably is preventing flu) and even keeping kids out of the classroom. “The major vector for influenza is children,” said David Topham, co-director of the New York Influenza Center of Excellence in Rochester. If they don’t get to breathe on each other like normal, they also can’t transmit as much flu. And that trick still works, even if flu isn’t the reason we’re keeping them distanced.
Influenza hasn’t been our target with all these interventions, but we’ve certainly given it a good pummelling. And that’s because flu just isn’t as transmissible as COVID-19.”
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“Our strategies are working on COVID-19, as well. Just not as dramatically, because it was more likely to spread to more people to begin with.”
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“Significantly reduced international travel has probably played a role in that, Brammer said. Usually, our flu season follows that of the Southern Hemisphere. But if there wasn’t much of one there, and there wasn’t much travel to transport the virus — the flu has no way to travel.”
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“scientists don’t know for certain what’s happening because the trouble with a really, really minuscule flu season is that it doesn’t leave you enough cases to make solid statistical inferences. We don’t know, for example, much about what happens when you get both the flu and COVID-19, because there haven’t been enough cases of it to do good research. We don’t really know how this bottleneck is affecting which strains of flu are circulating for the same reason. We don’t even know, for certain, that it is the masks and distancing that are squashing the flu because there are so few flu cases left to look at.”
“This fall and winter, health experts expect two types of deadly viruses to be circulating widely in the US. But they don’t yet know what the extent of the damage will be when the two collide.
In the absence of a coherent federal response, the novel coronavirus continues to spread across the country, with several states still battling active outbreaks. Experts estimate it could continue to hospitalize thousands and kill hundreds of people a day into September — likely with more spikes in the coming months.
We’re also now staring down the annual flu season, which typically starts in October and burdens the health care system even in normal years. The 2018–2019 flu season in the US, for example, resulted in about half a million hospitalizations and more than 34,000 deaths. The previous season, deaths were double that. And communities of color, which have already been disproportionately impacted by Covid-19, historically have also been more likely to have chronic health conditions that put them at higher risk of influenza-related complications.”
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“One problem is that because influenza and Covid-19 are both respiratory viruses, severe cases will be treated on much of the same limited medical equipment, like ventilators. And because they can have overlapping symptoms, figuring out whether someone has the flu or Covid-19 — or neither — will be tricky but also important.
Fortunately, we already have a safe vaccine for the flu, and nearly 200 million doses are slated to be available in the coming months.”
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“The Centers for Disease Control and Prevention (CDC) says that everyone 6 months and older (with very rare exceptions, like a life-threatening egg allergy) should get a flu shot. And this year, it is more crucial than ever to get one, experts say, to reduce the spread of the virus and keep the health care system from being overtaxed with continued surges of Covid-19.”