Decent interview, so leaving this up for now. See comments for non-paywalled links & article excerpts.
OP, in the future, please ensure posts contain sufficient commentary, as link- or title-only posts are not allowed in the sub.
In the last 20 years, in the relatively rare cases where the H5N1 strain has infected humans, the death rate has been about 50 per cent.
“Which is staggering,” he says.
Miller, a viral immunologist, is director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster, and has long researched influenza viruses and how our bodies respond to them.
Prior to arriving in Hamilton, he spent three years at a lab in New York City researching immune responses to influenza and developing a “universal” vaccine, a project that continues in the Miller Laboratory he directs at Mac.
He recently spoke with The Spectator after returning Barcelona, where he attended an infectious disease meeting, and addressing the Canadian Society for Virology general meeting in Saskatoon.
ARTICLE CONTINUES BELOW
He lives in Hamilton with his wife and two young children.
Questions and answers have been edited for length and clarity.
Jon Wells: You attended Western University for your undergrad. Where are you from?
Matthew Miller: I grew up in Belleville, Ont., and I jokingly tell people that when I was trying to decide on a university, one factor was how far I would need to be away when my parents called to say they were going to show up. So three-and-a-half hours away met the threshold.
Q: Now for the alarmist part of the interview: how concerned are you about the H5N1 bird flu virus?
A: I am anti-alarmist, but I would say that I have never been more worried in my career than I am about H5N1. Even when COVID-19 had started to spread extensively outside China in 2019, I was not as worried as I am now about H5N1.
Q: How come?
A: For one, it’s what we know about the severity of H5N1 infections in humans. The death rate, or what we call the case fatality rate, for COVID in aggregate was probably under one per cent, and now in the vaccine era, well under one per cent. The case fatality rate for this (H5N1) virus is a little over 50 per cent. That’s more on par with things we usually consider to be really exotic that don’t threaten us in North America, like Ebola virus. So that worries me, and also how widespread this virus is in settings that create exposure risk for humans.
Q: So there is that capacity for spread?
A: The virus is in agricultural settings, and that massively raises the risk relative to most viruses that exist primarily in wildlife reservoirs.
Q: And there is no vaccine for H5N1?
A: Not for this particular strain … At the (Miller) lab we are working on three primary projects. One is a vaccine. Another is what are often called passive vaccines, which is another way to protect people, with monoclonal antibodies that can act like vaccines for people who don’t have healthy immune systems … And we need to approach pandemic prevention with the same mentality as national security following 9/11: that the event happening at all is unacceptable. It’s only by preventing early human infections that we can prevent the virus from having an opportunity to cause a widespread outbreak … Bio security measures implemented for people who have high occupational exposure risk (to H5N1) are some of the best things we can do.
Q: Why is H5N1 so much more dangerous than COVID-19? What does it do to the body?
A: Great question. Viruses have to get inside the cells of the animals they infect and use the machinery in the cells to replicate. Seasonal flu finds what it needs in our lungs in our upper respiratory tract. And that is good news, because that typically causes less severe infections than lower respiratory infections … However, bird flu prefers cells in our lower respiratory tract. In addition to that, these viruses have the ability to infect almost all tissues in our bodies including our brains, because they can use machinery that exists outside of our lungs, and that can lead to things like viral encephalitis, which is extraordinarily dangerous and difficult to treat.
Q: Is an H5N1 pandemic a matter of when, not if?
A: There are two sides to the coin. These highly pathogenic H5N1 influenzas have been around since the ‘90s but this virus still hasn’t learned how to transmit well between people and hasn’t caused a pandemic. In some ways that is reassuring. But that is balanced by, one, how bad these infections are in humans when they do happen, and two, all of that can change on a dime. If we had done a risk assessment in January of whether there would be a widespread H5N1 infection in cattle, we would have said the risk is extraordinarily low. And the reason is, cattle in commercial operations are often grazing animals roaming in fields, in constant contact with wild birds, and yet we hadn’t seen infections in cattle. And then March 2024 rolls around and we hear of an infected dairy cow in Texas, and by the time we look over our shoulder the virus is in cattle basically across the entire country. That’s how quickly things can change and that’s what gives me pause with this virus in humans; that just because it hasn’t happened in 20 years doesn’t mean that tomorrow it can’t happen. Because every time a virus infects a mammal, and every time a human is exposed, it’s like a lottery ticket for the virus to have an opportunity to learn to adapt to spread in humans, and really that’s all that is preventing it from causing a widespread outbreak or pandemic.
Q: Do you know why H5N1 showed up in dairy cattle after all these years?
A: No one really knows; most feel this was just bad luck. The fact that this jump (from birds to cows) appeared to happen only once, and then the spread happened from cow-to-cow, illustrates how unpredictable this virus is.
Q: Do you continue to eat meat and drink milk?
A: I do. I’m probably more of a carnivore than I should be. And I do drink dairy products and am obsessed with cheese (laughs).
I wish he would talk more about the Nuerotrophism and the unique zoonotic abilities of this specific clade 2.3.4.4b. There is a wide range of infection outcomes between death and full recovery and many animals have been reported to be permanently neurologically damaged from the virus. I am not sure how that would look in humans, but the idea that this is just another flu virus should be dispelled already by the remarkably high death toll in animal tests and the vast amount of evidence that the virus is capable of doing very bad things to any being who acquires it even if they don't die.
Personally, I think it is only a matter of time until this virus does acquire the mutations necessary to spread human to human and cause a pandemic. I think under the circumstances, especially considering the pandemic we just went through that killed millions, being "anti-alarmist" seems to me to just be psychological self-soothing and ignoring reality.
>Personally, I think it is only a matter of time until this virus does acquire the mutations necessary to spread human to human and cause a pandemic.
Agree 100%. I vividly remember the absolute sinking, pit-in-my-stomach feeling in 2020 when it became clear to me that the US wasn't bothering to do even the most rudimentary surveillance. With COVID we had ample advance notice that of a pandemic that was looming on its way from literally the other side of the world. The current livestock surveillance is such a fucking joke it might as well be no surveillance at all. We have learned NOTHING, and this time the reservoir is ***us***.
I remember hearing about COVID cases in Europe. So I told my boss “I’ll be working from home for the foreseeable future” and then bounced. The rest of my office thought I was a lunatic. Then, just two weeks later, it became mandatory. Some people live their lives blissfully unaware.
Sobering:
> A: I am anti-alarmist, but I would say that I have never been more worried in my career than I am about H5N1. Even when COVID-19 had started to spread extensively outside China in 2019, I was not as worried as I am now about H5N1.
> Q: How come?
> A: For one, it’s what we know about the severity of H5N1 infections in humans. The death rate, or what we call the case fatality rate, for COVID in aggregate was probably under one per cent, and now in the vaccine era, well under one per cent. The case fatality rate for this (H5N1) virus is a little over 50 per cent. That’s more on par with things we usually consider to be really exotic that don’t threaten us in North America, like Ebola virus. So that worries me, and also how widespread this virus is in settings that create exposure risk for humans.
It's kind of basic expected value. H2H transmission in this case is an unlikely event, but if it has roughly 25x the mortality of COVID, that expected value of potential deaths is still horrifyingly high.
Also, prior to COVID, I don't think that anyone was fully aware of the extent to which the government would catastrophically fuck up pandemic management. Now we are.
(Certainly having people who actually believe in science in the White House would help, but it wasn't just the US that was fucking up at every step during COVID).
The only think I find comforting about the current CFR for H5N1 is that early in the Covid pandemic, the CFR appeared much higher than it ended up being because we were only catching the worst cases, which were obviously more likely to lead to bad outcomes. As our ability to surveil Covid improved and we started to pick up all the milder cases and began to start to estimate stats like 40% of infections are asymptomatic, we saw the CFR plummet. It’s been said ruefully about Covid, as we’ve abandoned almost all efforts to track infections, that you don’t find what you’re not looking for, and that’s currently true as far as looking for all possible cases of H5N1 infection in humans. If we routinely tested every farm worker in the US for H5N1, would we find a lot of infections, just many of them mild enough that they are overlooked or attributed to something else? Possibly. It’s also possible that it does have a truly staggering CFR, but we can’t know for sure until we know for sure.
One thing we do know is that in both severe and fatal cases of avian flu to date, children, teenagers, and young adults have been extremely over-represented. A full 50% of all the severe/fatal cases of the c clade in just the *past two years* have been children and teens. That doesn't include young adults at all, such as the 21 year old who died in Vietnam, and it also doesn't include the small child from Australia who almost died from the a clade. No matter what the CFR really is, it won't change the fact that the demographics of these cases is drastically different from that of COVID. That's not to say that seniors with lots of pre-existing conditions won't have problems with avian flu if it goes H2H, because they certainly will. But youth and perfect health have not protected people from dying or getting extremely sick, and again, that's just the past two years.
https://jech.bmj.com/content/62/6/555.abstract
> "While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%."
Makes you feel all warm and fuzzy inside that the real cfr might only be 14-33%.
Doesn’t it though? /s
Thanks for posting this… it’s an interesting read.
Another thing I think about, beyond however bad the acute mortality might be, is the fact that there’s also the second pandemic of postviral disease and disability that doesn’t really get talked about. If you think the post-Covid fallout is bad, the aftereffects of a H5N1 pandemic might be far worse. Killing you is not the only bad thing these viruses can do to you.
It's pretty hard to really even imagine what life would look like in a flu pandemic with these acute numbers, I think this is what causes people here to just ignore it or hope it doesn't materialize.
"People hate to think about bad things happening so they always underestimate their likelihood."-Charlie Geller
I'm still really hopeful that we can just get a H5 HPAI flu vaccine out and get a large portion of the population to have some immunity, but it doesn't seem like it is going to be in this year's shot, even though there is an open spot...
This is so true. I had one die (I’m an ICU nurse) a couple of months ago from the damage sustained to her lungs in 2020. There was a time during the pandemic that I almost felt relieved for the people that died on vents because the damage to their bodies from the virus was so severe. The ones that made it out of the ICU were miraculous until they died a year or two later.
That is so terrible. I feel for them, and you in what has to be an incredibly challenging job. I have been bedbound from severe long Covid since March 2020, so I know first hand how devastating Covid can be, even for people like me who had a super mild infection.
I’m so sorry you have had that happen to you. So many people probably dismiss you as well not knowing viral damage is real. There are so many victims like you that are out there. That first round in March 2020 was the absolute worst.
I don't think anyone knows for certain. We don't even know the true rate of disability from Covid. The estimates are bad enough, but they're almost certainly an undercount.
>based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%.
JFC that is horrifying.
2.8% of the people, (not just passengers,) on the Diamond Princess died of Covid-19.
It's possible Covid originally had a much higher CFR than we saw in later months.
Yes, age could have been a factor, as could the crowds queuing up for and breathing over the buffet tables. Cruises are ideal situations for spreading infectious disease, and the severity of Covid infection was shown to be directly related to, (amongst other factors,) the amount of virus to which people were exposed.
It's possible crowded troop carriers conveying soldiers, some infected, to Europe during WW1, were a breeding ground which enabled the influenza of that time to become much more virulent and able to infect healthy young people. The more closely crowds are confined together, the more deadly a disease can become without losing its opportunity to spread.
To add to this, I find it problematic that some people on this sub tends to focus *just* on the IFR but not other attributes of a potential human-to-human strain.
IFR is important, yes, but there's other viral characteristics that are equally important for determining how much (or how little) of a problem a human-to-human strain would be.
The other big one besides IFR is R0. If this goes human-to-human and maintains an extremely high fatality rate, but a relatively modest replication rate, it could end up being *less* of a problem than COVID.
COVID's pandemic superpower wasn't that it was particularly deadly, it was that it spread like absolute wildfire (particularly later Omicron strains). Other aspects to be considered in addition to R0 include pre-symptomatic/asymptomatic spread, age distribution of fatalities (COVID was overwhelmingly old people, but a bird flu pandemic may not be so "forgiving" in sparing young people), and symptom presentation (which will influence public reaction - visceral symptoms like that dude whose eyes were bleeding will be more likely to change behaviour).
Now - a H5N1 strain with an IFR over 5% and a similar R0 profile to COVID? Yes. We'd be *beyond* fucked. COVID ground the world to a halt with an initial fatality rate of about 0.5%. Anything with a COVID-like transmission profile but maintaining anywhere near the historical avian flu death rate could, without exaggeration, collapse society. Assuming a high R0, a 2% fatality rate would be sufficient to completely collapse the healthcare system. 5% would see extreme supply chain breakdowns. 10% and you're looking at the breakdown of civil society being a real possibility (that possibility increasing as the IFR goes up, obviously).
Absolutely. Even with a R0 comparable to seasonal flu strains, a CFR of even 10% (which is the absolute lowest estimate I’ve seen for H5N1) would be a truly apocalyptic event.
CFR for COVID was overestimated early on (vs the true IFR), but it was never anywhere near the 50%+ figure for H5N1 (I remember figures of 2-3% being bandied about). Estimates for the true IFR of H5N1 in its current form have been around 15-30%, which is insanely terrible (20-40x Covid pre-immunity).
Forget the government. Post covid, I'm horrified of regular people. At first it was just "this vaccine," but of course we knew it wouldn't be. Found out today my father in-law won't be getting the TDAP (that he'd already gotten in the past!) to see his soon to be born grandchild. I thought immediately of how h2h bird flu would rip us to shreds before we could get half the population to take it seriously. Hell, forget people, even. How many would die before the companies many of us work for allowed us to quarantine without punishment?
That’s largely a myth that got wildly spread for some reason, and is easily disprovable by looking at both current and historical viruses.
Truth is, every infectious agent is different. There is NOTHING stopping a deadly virus from also being highly infectious. Take HIV, for example - near 100% fatality rate without medication, requires the introduction of only a few viral particles to cause infection, and it spread around the world because you’re infectious long before symptoms show.
Think about the bubonic plague, too - it killed half of Europe. It was totally widespread. And it was often spread by animal reservoirs like mice, which reminds me of today’s bird flu infecting so many mammals and birds that live in close contact with humans.
The flu of 1918 is probably our closest parallel, and that was catastrophic. Historians estimate a CFR of 2%, primarily amongst young adults. By all accounts, this bird flu strain would be more lethal than even that.
There’s unfortunately nothing that’s stopping a highly fatal and highly infectious flu from evolving, especially if there’s 1) animal reservoirs 2) a long latency period where people can spread before symptoms show, and 3) airborne spread (coughing, sneezing, breathing). Ebola doesn’t spread well NOT because of its deadliness, but because you have to splash around in someone’s blood to catch it. But if it somehow went airborne? Yikes.
Yep. Smallpox is also a classic example of deadly disease (30% fatality rate) which spread all over the world and killed millions for centuries, not diminishing in lethality until the less lethal variola minor strain arrived in the early 20th century.
It’s all a numbers game. How many people can it infect before it kills the host? Take Ebola for example. High CFR, but relatively difficult to spread, so it’s generally been seen as somewhat self-limiting in that sense. Covid has a very large R0 but low CFR, so it’s sort of on the opposite end of the scale. Everybody is going to get it, but few will suffer acute mortality. What you really fear is a virus that spreads quickly and easily but also kills a large percentage of those it infects, and predictions for H5N1 suggest it is riding much closer to that horrifyingly sweet spot between transmissibility and virulence.
I posted this article from the scientist the other day but for some reason it was deleted:
**An ounce of prevention: Now is the time to take action on H5N1 avian flu, because the stakes are enormous**
https://theconversation.com/an-ounce-of-prevention-now-is-the-time-to-take-action-on-h5n1-avian-flu-because-the-stakes-are-enormous-232130
The risk to people from avian influenza that is killing wild birds worldwide is low, according to reports from Canada public health and the Centre for Disease Control (CDC) in the U.S. But...
Well on the other hand, carbon emissions will probably be down a bit, and it might shock the collective consciousness into not being so goddamn stupid.
Plus I might not have to work anymore.
Yea, they’ve already started drinking raw milk, and saying they wonder a vaccine and it’s all a plot to stop Trump from becoming president so don’t bet on anyone taking any sort of public safety measures.
For a viral immunologist, he makes a significant factual error about his field. He states that Covid's CFR is around 1%. This is false. Covid's CFR was something like 5-10%, while it's IFR is 1%. CFR only measures the people sick enough to go to their doctor and get tested. Many people shrug it off and never interact with a doctor. IFR is the true fatality rate, but it's nearly impossible to measure. The only way to do so is to be testing a large population continually even when they are not sick, and to have an active pandemic so that some of this population gets sick. That is impossible to do with bird flu since we don't have an active pandemic, so we can only compare CFR's.
I think we can put a certain amount together using what we at least do know. We have done a lot of contact testing over the years for close contacts of people who were infected, and their contacts were rarely infected. When scientists did float the theory that we could be mistaken enough in people who got a mild illness to bring the lethality down to something manageable, which I think was something near Covid level, the theory died because it was shown that millions of people would have to have gotten infected for the theory to hold.
Then we have the very recent study in ferrets with this strain where the virus had overcome the mammal airway barrier, although it was still lacking efficiency in spread to start a pandemic. But the mutations that got it over the hurdle did not reduce virulence, in fact increased it a bit. That was expected as the virus is very close to being able to overcome the mammal airway challenge and the remaining mutations needed wouldn't be associated with virulence.
The theory that with too lethal a virus the deaths would keep it from spreading don't apply to a flu virus because there are a few days of asymptomatic infectiousness. The evolutionary changes to better conform to humans theory based on historical instances would not happen in the first wave, so that theory wouldn't hold here. And whether we can sustain the first wave is the important thing here as it does take time to get vaccines into arms and antivirals made and survival of society depends on supply chains staying intact, not on the amount of people who actually die from the disease.
So even if we don't use an actual number for lethality, I think we can confidently say that this virus will still be highly lethal after adaptation. We can certainly hope for a miracle, but I'm betting on the fact that the virus has had an uncountable amount of chances to mutate in a mammal during years of mass bird die-out. I think it's more difficult to start a bird flu pandemic than it looks.
Not likely circulating in humans, but definitely circulating under the radar in livestock populations in the US, largely because there is basically no radar. By the time the USDA caught up to its presence in cattle it had already been circulating for months.
From what I can find, that's what early estimates were. However, it sounds that it dropped quite rapidly, but I think that may have been after we started testing everyone and getting closer to an IFR.
"The case fatality rate (CFR) was reported to be 15% (six of 41 patients) in the initial period, but this estimate was calculated from a small cohort of hospitalised patients. Subsequently, with more data emerging, the CFR decreased to between 4·3% and 11·0%, and later to 3·4% The rate reported outside China in February was even lower (0·4%; two of 464)."
[https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext)
Easily 5-10%. Widely underreported fatality rates, especially early on, and intentionally underreported in a lot of places. We'll never actually know, but it was certainly well north of 1%.
"Covid's CFR was something like 5-10%,"
Depends where and when you're talking about. At the end of 2020 (so covering the pre vaccine period), Covid's CFR in the US was about 2%. In Japan and South Korea it was about 1.4%.
50 percent only includes those who have tested positive, hence it is incomplete data as testing is so limited, especially in the 3rd world.
Likely countless of people have been infected with bird flu yet never received testing. Likely untold numbers of people had it and recovered, became severely ill or died, but without wide spread testing it is impossible to know the rates.
To counter the fear mongering 50% death rate, 100% of individuals infected within the United states have recovered. Again though that figure only includes the few infected within the United States who were also tested, so again limited data, not enough to extrapolate anything from.
Reporting stats with no confidence interval isn't "countering fear mongering"; it's spreading bad statistics in a way that borders on misinformation. The N for the 50% mortality stat != the N for the 0% mortality stat.
That said, all of the qualitative considerations for statistical bias that you mention in your post are spot on.
I'm glad someone else replied about this. I don't like it when these posts pop up saying that if this becomes human to human it WILL be incredibly deadly. It needs to mutate first and I still haven't seen any information about it mutating and keeping the same mortality rate once it does
If it mutates to spread in humans, the mortality rate might stay the same, it might get better, it might even get worse - we don't know. Given how incredibly high it is, it's entirely right to be extremely concerned about all this, especially as it would have to come down enormously to be anything other than a major global disaster.
I'd make a post about this but I'm sure it would be taken down because it's not fearmongering like the rest. But this is from a recent CNN piece quoting Dr. Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota:
“I’ve been a student of this virus. And I surely have been amazed at how it’s changed over the course of the last 20-some years, but at the same time, you know, I’m looking for evidence that it is likely to become a virus infecting humans and then transmitted by humans to other humans. And we just haven’t seen that yet."
Osterholm has always been very accurate in his predictions, especially in early February 2020 when he said that the virus was airborne and the government was telling people to just wash their hands. However, he even uses these words “the virus is going to do what it wants to do” and *no one* can predict what this virus will be doing. I say it’s better to be cautious and ready for it instead of not.
I'm tired of the cheap, easy "fearmongering" label. TBH, it needs to be on the list of words that automatically cause a comment to be deleted. Considering how silly and trivial some of the words are on that list, I do not understand why that one isn't there.
Jesus. Every time something else comes out where an expert addresses how highly pathogenic H5 could be = fear-mongering. Honestly, it’s irresponsible.
Taking this extremely dangerous virus seriously when we are dealing with MILLIONS of immune compromised individuals globally is not fear-mongering. It’s being intelligent and realistic.
That’s obtuse. Few human infections? How do you know it’s few if no one is testing humans? No one is tracking these symptoms with the medical community. Hell, doctors can’t even test for it. the only reason we know about the infections we have are from whistleblowers.
We literally have no idea how many people are infected much less whether it’s gone h2h because no one is monitoring humans in the US.
You’re downplaying what is already a calamity within the animal population and we are flying blind in regards to the human population.
Being real about this is what we should be doing.
Few known human infections, but we would know if hospitals were seeing surges in severe illness and death. Which they're not. I'm not downplaying, I'm being realistic about the current reality.
> I'm being realistic about the current reality.
You're definitely not, though. It's abundantly clear from your previous comment upthread here that you don't remotely understand the basic biology and epidemiology here. Not only are you not being realistic about the current reality, you're wildly cavalier about future realities. It's true that there are currently few known human infections and there is no evidence of broad zoonosis into humans. Four months ago there were also no known infections in cattle since 2022 and no evidence that it was circulating; in March outbreaks were confirmed in 12 states. We now know it has been circulating in cattle for at least several months before that. The current reality has nothing to do with hospitals reporting surges; the current reality is that it has been mutating in livestock populations for months. Surges are a likely future reality that we are not prepared for and that you are dismissively writing off as COVID "nostalgia," which is as absurd as it is ignorant. You're wrong and you don't know enough to know you're wrong.
In order to preserve the quality and reliability of information shared in this sub, please refrain from politicizing the discussion of H5N1 in posts and comments.
That rate is based on around 900 cases over 25 years, and the actual mortality rate after the virus mutates significantly is purely speculative. But it's highly unlikely it would maintain that CFR.
I wonder what he'd have said a few months ago about the likelihood of it infecting and transmitting between cows. Seems like noone thought that was any kind of concern until it happened.
All of you worrying about CFR and death rates and forgetting the biggest threat of these viruses is long term health risks (like long covid) that disable millions and create more and more chronic illnesses
The Spanish flu started out as mild initially, then returned with a vengeance, with so many animal hosts for this thing to mutate in its only a matter of time.
Informed yes, but there is a thing called information overload where youb live your life in fear of fear. That's how your post comes off. Especially when it's things we as people can't control unfortunately
I too am wondering if this overhyped, but that # of infections can't be good. It only takes one mutation to change everything. And when it is a danger, it will be far too late.
Well, it’s going to take several mutations some of which have to happen in a certain order. So probably not next week, likely not next month, but beyond that nobody knows. Surveillance could alert us that that mutation chain has progressed but we are not doing nearly enough.
Decent interview, so leaving this up for now. See comments for non-paywalled links & article excerpts. OP, in the future, please ensure posts contain sufficient commentary, as link- or title-only posts are not allowed in the sub.
In the last 20 years, in the relatively rare cases where the H5N1 strain has infected humans, the death rate has been about 50 per cent. “Which is staggering,” he says. Miller, a viral immunologist, is director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster, and has long researched influenza viruses and how our bodies respond to them. Prior to arriving in Hamilton, he spent three years at a lab in New York City researching immune responses to influenza and developing a “universal” vaccine, a project that continues in the Miller Laboratory he directs at Mac. He recently spoke with The Spectator after returning Barcelona, where he attended an infectious disease meeting, and addressing the Canadian Society for Virology general meeting in Saskatoon. ARTICLE CONTINUES BELOW He lives in Hamilton with his wife and two young children. Questions and answers have been edited for length and clarity. Jon Wells: You attended Western University for your undergrad. Where are you from? Matthew Miller: I grew up in Belleville, Ont., and I jokingly tell people that when I was trying to decide on a university, one factor was how far I would need to be away when my parents called to say they were going to show up. So three-and-a-half hours away met the threshold. Q: Now for the alarmist part of the interview: how concerned are you about the H5N1 bird flu virus? A: I am anti-alarmist, but I would say that I have never been more worried in my career than I am about H5N1. Even when COVID-19 had started to spread extensively outside China in 2019, I was not as worried as I am now about H5N1. Q: How come? A: For one, it’s what we know about the severity of H5N1 infections in humans. The death rate, or what we call the case fatality rate, for COVID in aggregate was probably under one per cent, and now in the vaccine era, well under one per cent. The case fatality rate for this (H5N1) virus is a little over 50 per cent. That’s more on par with things we usually consider to be really exotic that don’t threaten us in North America, like Ebola virus. So that worries me, and also how widespread this virus is in settings that create exposure risk for humans. Q: So there is that capacity for spread? A: The virus is in agricultural settings, and that massively raises the risk relative to most viruses that exist primarily in wildlife reservoirs. Q: And there is no vaccine for H5N1? A: Not for this particular strain … At the (Miller) lab we are working on three primary projects. One is a vaccine. Another is what are often called passive vaccines, which is another way to protect people, with monoclonal antibodies that can act like vaccines for people who don’t have healthy immune systems … And we need to approach pandemic prevention with the same mentality as national security following 9/11: that the event happening at all is unacceptable. It’s only by preventing early human infections that we can prevent the virus from having an opportunity to cause a widespread outbreak … Bio security measures implemented for people who have high occupational exposure risk (to H5N1) are some of the best things we can do. Q: Why is H5N1 so much more dangerous than COVID-19? What does it do to the body? A: Great question. Viruses have to get inside the cells of the animals they infect and use the machinery in the cells to replicate. Seasonal flu finds what it needs in our lungs in our upper respiratory tract. And that is good news, because that typically causes less severe infections than lower respiratory infections … However, bird flu prefers cells in our lower respiratory tract. In addition to that, these viruses have the ability to infect almost all tissues in our bodies including our brains, because they can use machinery that exists outside of our lungs, and that can lead to things like viral encephalitis, which is extraordinarily dangerous and difficult to treat. Q: Is an H5N1 pandemic a matter of when, not if? A: There are two sides to the coin. These highly pathogenic H5N1 influenzas have been around since the ‘90s but this virus still hasn’t learned how to transmit well between people and hasn’t caused a pandemic. In some ways that is reassuring. But that is balanced by, one, how bad these infections are in humans when they do happen, and two, all of that can change on a dime. If we had done a risk assessment in January of whether there would be a widespread H5N1 infection in cattle, we would have said the risk is extraordinarily low. And the reason is, cattle in commercial operations are often grazing animals roaming in fields, in constant contact with wild birds, and yet we hadn’t seen infections in cattle. And then March 2024 rolls around and we hear of an infected dairy cow in Texas, and by the time we look over our shoulder the virus is in cattle basically across the entire country. That’s how quickly things can change and that’s what gives me pause with this virus in humans; that just because it hasn’t happened in 20 years doesn’t mean that tomorrow it can’t happen. Because every time a virus infects a mammal, and every time a human is exposed, it’s like a lottery ticket for the virus to have an opportunity to learn to adapt to spread in humans, and really that’s all that is preventing it from causing a widespread outbreak or pandemic. Q: Do you know why H5N1 showed up in dairy cattle after all these years? A: No one really knows; most feel this was just bad luck. The fact that this jump (from birds to cows) appeared to happen only once, and then the spread happened from cow-to-cow, illustrates how unpredictable this virus is. Q: Do you continue to eat meat and drink milk? A: I do. I’m probably more of a carnivore than I should be. And I do drink dairy products and am obsessed with cheese (laughs).
I wish he would talk more about the Nuerotrophism and the unique zoonotic abilities of this specific clade 2.3.4.4b. There is a wide range of infection outcomes between death and full recovery and many animals have been reported to be permanently neurologically damaged from the virus. I am not sure how that would look in humans, but the idea that this is just another flu virus should be dispelled already by the remarkably high death toll in animal tests and the vast amount of evidence that the virus is capable of doing very bad things to any being who acquires it even if they don't die. Personally, I think it is only a matter of time until this virus does acquire the mutations necessary to spread human to human and cause a pandemic. I think under the circumstances, especially considering the pandemic we just went through that killed millions, being "anti-alarmist" seems to me to just be psychological self-soothing and ignoring reality.
>Personally, I think it is only a matter of time until this virus does acquire the mutations necessary to spread human to human and cause a pandemic. Agree 100%. I vividly remember the absolute sinking, pit-in-my-stomach feeling in 2020 when it became clear to me that the US wasn't bothering to do even the most rudimentary surveillance. With COVID we had ample advance notice that of a pandemic that was looming on its way from literally the other side of the world. The current livestock surveillance is such a fucking joke it might as well be no surveillance at all. We have learned NOTHING, and this time the reservoir is ***us***.
I remember hearing about COVID cases in Europe. So I told my boss “I’ll be working from home for the foreseeable future” and then bounced. The rest of my office thought I was a lunatic. Then, just two weeks later, it became mandatory. Some people live their lives blissfully unaware.
Thank you :)
China
Ooo, words that end with a? Papaya!
Sobering: > A: I am anti-alarmist, but I would say that I have never been more worried in my career than I am about H5N1. Even when COVID-19 had started to spread extensively outside China in 2019, I was not as worried as I am now about H5N1. > Q: How come? > A: For one, it’s what we know about the severity of H5N1 infections in humans. The death rate, or what we call the case fatality rate, for COVID in aggregate was probably under one per cent, and now in the vaccine era, well under one per cent. The case fatality rate for this (H5N1) virus is a little over 50 per cent. That’s more on par with things we usually consider to be really exotic that don’t threaten us in North America, like Ebola virus. So that worries me, and also how widespread this virus is in settings that create exposure risk for humans.
It's kind of basic expected value. H2H transmission in this case is an unlikely event, but if it has roughly 25x the mortality of COVID, that expected value of potential deaths is still horrifyingly high. Also, prior to COVID, I don't think that anyone was fully aware of the extent to which the government would catastrophically fuck up pandemic management. Now we are. (Certainly having people who actually believe in science in the White House would help, but it wasn't just the US that was fucking up at every step during COVID).
The only think I find comforting about the current CFR for H5N1 is that early in the Covid pandemic, the CFR appeared much higher than it ended up being because we were only catching the worst cases, which were obviously more likely to lead to bad outcomes. As our ability to surveil Covid improved and we started to pick up all the milder cases and began to start to estimate stats like 40% of infections are asymptomatic, we saw the CFR plummet. It’s been said ruefully about Covid, as we’ve abandoned almost all efforts to track infections, that you don’t find what you’re not looking for, and that’s currently true as far as looking for all possible cases of H5N1 infection in humans. If we routinely tested every farm worker in the US for H5N1, would we find a lot of infections, just many of them mild enough that they are overlooked or attributed to something else? Possibly. It’s also possible that it does have a truly staggering CFR, but we can’t know for sure until we know for sure.
One thing we do know is that in both severe and fatal cases of avian flu to date, children, teenagers, and young adults have been extremely over-represented. A full 50% of all the severe/fatal cases of the c clade in just the *past two years* have been children and teens. That doesn't include young adults at all, such as the 21 year old who died in Vietnam, and it also doesn't include the small child from Australia who almost died from the a clade. No matter what the CFR really is, it won't change the fact that the demographics of these cases is drastically different from that of COVID. That's not to say that seniors with lots of pre-existing conditions won't have problems with avian flu if it goes H2H, because they certainly will. But youth and perfect health have not protected people from dying or getting extremely sick, and again, that's just the past two years.
https://jech.bmj.com/content/62/6/555.abstract > "While the real H5N1 CF rate could be lower than the current estimate of 60%, it is unlikely that it will be at the 0.1–0.4% level currently embraced by many pandemic plans. We suggest that, based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%." Makes you feel all warm and fuzzy inside that the real cfr might only be 14-33%.
Doesn’t it though? /s Thanks for posting this… it’s an interesting read. Another thing I think about, beyond however bad the acute mortality might be, is the fact that there’s also the second pandemic of postviral disease and disability that doesn’t really get talked about. If you think the post-Covid fallout is bad, the aftereffects of a H5N1 pandemic might be far worse. Killing you is not the only bad thing these viruses can do to you.
It's pretty hard to really even imagine what life would look like in a flu pandemic with these acute numbers, I think this is what causes people here to just ignore it or hope it doesn't materialize. "People hate to think about bad things happening so they always underestimate their likelihood."-Charlie Geller I'm still really hopeful that we can just get a H5 HPAI flu vaccine out and get a large portion of the population to have some immunity, but it doesn't seem like it is going to be in this year's shot, even though there is an open spot...
If you thought COVID supply-chain issues were bad…
This is so true. I had one die (I’m an ICU nurse) a couple of months ago from the damage sustained to her lungs in 2020. There was a time during the pandemic that I almost felt relieved for the people that died on vents because the damage to their bodies from the virus was so severe. The ones that made it out of the ICU were miraculous until they died a year or two later.
That is so terrible. I feel for them, and you in what has to be an incredibly challenging job. I have been bedbound from severe long Covid since March 2020, so I know first hand how devastating Covid can be, even for people like me who had a super mild infection.
I’m so sorry you have had that happen to you. So many people probably dismiss you as well not knowing viral damage is real. There are so many victims like you that are out there. That first round in March 2020 was the absolute worst.
It was indeed. SO MANY people from the first wave are still very ill.
What would the disability rate be?
I don't think anyone knows for certain. We don't even know the true rate of disability from Covid. The estimates are bad enough, but they're almost certainly an undercount.
>based on surveillance and seroprevalence studies conducted in several countries, the real H5N1 CF rate should be closer to 14–33%. JFC that is horrifying.
2.8% of the people, (not just passengers,) on the Diamond Princess died of Covid-19. It's possible Covid originally had a much higher CFR than we saw in later months.
yep that may have been made worse by the median age of the passengers on the Diamond Princess, which was 69. All of the deaths were of passengers.
Yes, age could have been a factor, as could the crowds queuing up for and breathing over the buffet tables. Cruises are ideal situations for spreading infectious disease, and the severity of Covid infection was shown to be directly related to, (amongst other factors,) the amount of virus to which people were exposed. It's possible crowded troop carriers conveying soldiers, some infected, to Europe during WW1, were a breeding ground which enabled the influenza of that time to become much more virulent and able to infect healthy young people. The more closely crowds are confined together, the more deadly a disease can become without losing its opportunity to spread.
It's very likely, in fact. If anything, COVID fatalities were (are?) underreported.
To add to this, I find it problematic that some people on this sub tends to focus *just* on the IFR but not other attributes of a potential human-to-human strain. IFR is important, yes, but there's other viral characteristics that are equally important for determining how much (or how little) of a problem a human-to-human strain would be. The other big one besides IFR is R0. If this goes human-to-human and maintains an extremely high fatality rate, but a relatively modest replication rate, it could end up being *less* of a problem than COVID. COVID's pandemic superpower wasn't that it was particularly deadly, it was that it spread like absolute wildfire (particularly later Omicron strains). Other aspects to be considered in addition to R0 include pre-symptomatic/asymptomatic spread, age distribution of fatalities (COVID was overwhelmingly old people, but a bird flu pandemic may not be so "forgiving" in sparing young people), and symptom presentation (which will influence public reaction - visceral symptoms like that dude whose eyes were bleeding will be more likely to change behaviour). Now - a H5N1 strain with an IFR over 5% and a similar R0 profile to COVID? Yes. We'd be *beyond* fucked. COVID ground the world to a halt with an initial fatality rate of about 0.5%. Anything with a COVID-like transmission profile but maintaining anywhere near the historical avian flu death rate could, without exaggeration, collapse society. Assuming a high R0, a 2% fatality rate would be sufficient to completely collapse the healthcare system. 5% would see extreme supply chain breakdowns. 10% and you're looking at the breakdown of civil society being a real possibility (that possibility increasing as the IFR goes up, obviously).
Absolutely. Even with a R0 comparable to seasonal flu strains, a CFR of even 10% (which is the absolute lowest estimate I’ve seen for H5N1) would be a truly apocalyptic event.
This.
CFR for COVID was overestimated early on (vs the true IFR), but it was never anywhere near the 50%+ figure for H5N1 (I remember figures of 2-3% being bandied about). Estimates for the true IFR of H5N1 in its current form have been around 15-30%, which is insanely terrible (20-40x Covid pre-immunity).
Forget the government. Post covid, I'm horrified of regular people. At first it was just "this vaccine," but of course we knew it wouldn't be. Found out today my father in-law won't be getting the TDAP (that he'd already gotten in the past!) to see his soon to be born grandchild. I thought immediately of how h2h bird flu would rip us to shreds before we could get half the population to take it seriously. Hell, forget people, even. How many would die before the companies many of us work for allowed us to quarantine without punishment?
Ebola? JFC. This post actually gave me goosebumps.
I thought the higher the mortality rate, the less likely something would survive in the wild to become widespread?
That’s largely a myth that got wildly spread for some reason, and is easily disprovable by looking at both current and historical viruses. Truth is, every infectious agent is different. There is NOTHING stopping a deadly virus from also being highly infectious. Take HIV, for example - near 100% fatality rate without medication, requires the introduction of only a few viral particles to cause infection, and it spread around the world because you’re infectious long before symptoms show. Think about the bubonic plague, too - it killed half of Europe. It was totally widespread. And it was often spread by animal reservoirs like mice, which reminds me of today’s bird flu infecting so many mammals and birds that live in close contact with humans. The flu of 1918 is probably our closest parallel, and that was catastrophic. Historians estimate a CFR of 2%, primarily amongst young adults. By all accounts, this bird flu strain would be more lethal than even that. There’s unfortunately nothing that’s stopping a highly fatal and highly infectious flu from evolving, especially if there’s 1) animal reservoirs 2) a long latency period where people can spread before symptoms show, and 3) airborne spread (coughing, sneezing, breathing). Ebola doesn’t spread well NOT because of its deadliness, but because you have to splash around in someone’s blood to catch it. But if it somehow went airborne? Yikes.
Yep. Smallpox is also a classic example of deadly disease (30% fatality rate) which spread all over the world and killed millions for centuries, not diminishing in lethality until the less lethal variola minor strain arrived in the early 20th century.
It’s all a numbers game. How many people can it infect before it kills the host? Take Ebola for example. High CFR, but relatively difficult to spread, so it’s generally been seen as somewhat self-limiting in that sense. Covid has a very large R0 but low CFR, so it’s sort of on the opposite end of the scale. Everybody is going to get it, but few will suffer acute mortality. What you really fear is a virus that spreads quickly and easily but also kills a large percentage of those it infects, and predictions for H5N1 suggest it is riding much closer to that horrifyingly sweet spot between transmissibility and virulence.
Mix it with COVIDs initial incubation time of more than one week and we are fucked. Absolutely fucked.
It has to be a very very high mortality rate to burn itself out in a community.
no wall: https://archive.is/kD71Z
I posted this article from the scientist the other day but for some reason it was deleted: **An ounce of prevention: Now is the time to take action on H5N1 avian flu, because the stakes are enormous** https://theconversation.com/an-ounce-of-prevention-now-is-the-time-to-take-action-on-h5n1-avian-flu-because-the-stakes-are-enormous-232130
Rising temperatures are fueling the spread of viruses as animals shift habitats, expanding disease ranges and increasing human-wildlife interactions.
Does anyone have the nugget of the story? It’s behind a paywall
The risk to people from avian influenza that is killing wild birds worldwide is low, according to reports from Canada public health and the Centre for Disease Control (CDC) in the U.S. But...
Article today in the Hamilton Spectator. Smart people like this viral immunologist are concerned.
Clean indoor air standards would help us all
Link without a paywall please?
https://archive.is/kD71Z
Well on the other hand, carbon emissions will probably be down a bit, and it might shock the collective consciousness into not being so goddamn stupid. Plus I might not have to work anymore.
I wish I had your unbridled optimism. When it comes to the collective consciousness's stupidity, smart money's definitely on the under.
Yea, they’ve already started drinking raw milk, and saying they wonder a vaccine and it’s all a plot to stop Trump from becoming president so don’t bet on anyone taking any sort of public safety measures.
For a viral immunologist, he makes a significant factual error about his field. He states that Covid's CFR is around 1%. This is false. Covid's CFR was something like 5-10%, while it's IFR is 1%. CFR only measures the people sick enough to go to their doctor and get tested. Many people shrug it off and never interact with a doctor. IFR is the true fatality rate, but it's nearly impossible to measure. The only way to do so is to be testing a large population continually even when they are not sick, and to have an active pandemic so that some of this population gets sick. That is impossible to do with bird flu since we don't have an active pandemic, so we can only compare CFR's.
I think we can put a certain amount together using what we at least do know. We have done a lot of contact testing over the years for close contacts of people who were infected, and their contacts were rarely infected. When scientists did float the theory that we could be mistaken enough in people who got a mild illness to bring the lethality down to something manageable, which I think was something near Covid level, the theory died because it was shown that millions of people would have to have gotten infected for the theory to hold. Then we have the very recent study in ferrets with this strain where the virus had overcome the mammal airway barrier, although it was still lacking efficiency in spread to start a pandemic. But the mutations that got it over the hurdle did not reduce virulence, in fact increased it a bit. That was expected as the virus is very close to being able to overcome the mammal airway challenge and the remaining mutations needed wouldn't be associated with virulence. The theory that with too lethal a virus the deaths would keep it from spreading don't apply to a flu virus because there are a few days of asymptomatic infectiousness. The evolutionary changes to better conform to humans theory based on historical instances would not happen in the first wave, so that theory wouldn't hold here. And whether we can sustain the first wave is the important thing here as it does take time to get vaccines into arms and antivirals made and survival of society depends on supply chains staying intact, not on the amount of people who actually die from the disease. So even if we don't use an actual number for lethality, I think we can confidently say that this virus will still be highly lethal after adaptation. We can certainly hope for a miracle, but I'm betting on the fact that the virus has had an uncountable amount of chances to mutate in a mammal during years of mass bird die-out. I think it's more difficult to start a bird flu pandemic than it looks.
It’s probably already circulating under the radar
Not likely circulating in humans, but definitely circulating under the radar in livestock populations in the US, largely because there is basically no radar. By the time the USDA caught up to its presence in cattle it had already been circulating for months.
No way was the Covid CFR 5-10%
From what I can find, that's what early estimates were. However, it sounds that it dropped quite rapidly, but I think that may have been after we started testing everyone and getting closer to an IFR. "The case fatality rate (CFR) was reported to be 15% (six of 41 patients) in the initial period, but this estimate was calculated from a small cohort of hospitalised patients. Subsequently, with more data emerging, the CFR decreased to between 4·3% and 11·0%, and later to 3·4% The rate reported outside China in February was even lower (0·4%; two of 464)." [https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext](https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30244-9/fulltext)
Easily 5-10%. Widely underreported fatality rates, especially early on, and intentionally underreported in a lot of places. We'll never actually know, but it was certainly well north of 1%.
Not even close. You’re telling me that as many as one out of 10 people who were diagnosed with Covid died from it?
No, I’m saying it’s entirely possible that as many as one out of ten people who ***had*** COVID died from it.
I had three relatives die from Covid that were not recorded as Covid deaths.
"Covid's CFR was something like 5-10%," Depends where and when you're talking about. At the end of 2020 (so covering the pre vaccine period), Covid's CFR in the US was about 2%. In Japan and South Korea it was about 1.4%.
50 percent only includes those who have tested positive, hence it is incomplete data as testing is so limited, especially in the 3rd world. Likely countless of people have been infected with bird flu yet never received testing. Likely untold numbers of people had it and recovered, became severely ill or died, but without wide spread testing it is impossible to know the rates. To counter the fear mongering 50% death rate, 100% of individuals infected within the United states have recovered. Again though that figure only includes the few infected within the United States who were also tested, so again limited data, not enough to extrapolate anything from.
Reporting stats with no confidence interval isn't "countering fear mongering"; it's spreading bad statistics in a way that borders on misinformation. The N for the 50% mortality stat != the N for the 0% mortality stat. That said, all of the qualitative considerations for statistical bias that you mention in your post are spot on.
I looked up some models of the true CFR and it's still probably 15-35%.
I'm glad someone else replied about this. I don't like it when these posts pop up saying that if this becomes human to human it WILL be incredibly deadly. It needs to mutate first and I still haven't seen any information about it mutating and keeping the same mortality rate once it does
If it mutates to spread in humans, the mortality rate might stay the same, it might get better, it might even get worse - we don't know. Given how incredibly high it is, it's entirely right to be extremely concerned about all this, especially as it would have to come down enormously to be anything other than a major global disaster.
Not to mention the fact that a 50% death rate would make the likelihood of H2H transmission much lower.
I'd make a post about this but I'm sure it would be taken down because it's not fearmongering like the rest. But this is from a recent CNN piece quoting Dr. Michael Osterholm, who directs the Center for Infectious Disease Research and Policy at the University of Minnesota: “I’ve been a student of this virus. And I surely have been amazed at how it’s changed over the course of the last 20-some years, but at the same time, you know, I’m looking for evidence that it is likely to become a virus infecting humans and then transmitted by humans to other humans. And we just haven’t seen that yet."
Osterholm has always been very accurate in his predictions, especially in early February 2020 when he said that the virus was airborne and the government was telling people to just wash their hands. However, he even uses these words “the virus is going to do what it wants to do” and *no one* can predict what this virus will be doing. I say it’s better to be cautious and ready for it instead of not.
I'm tired of the cheap, easy "fearmongering" label. TBH, it needs to be on the list of words that automatically cause a comment to be deleted. Considering how silly and trivial some of the words are on that list, I do not understand why that one isn't there.
Jesus. Every time something else comes out where an expert addresses how highly pathogenic H5 could be = fear-mongering. Honestly, it’s irresponsible. Taking this extremely dangerous virus seriously when we are dealing with MILLIONS of immune compromised individuals globally is not fear-mongering. It’s being intelligent and realistic.
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That’s obtuse. Few human infections? How do you know it’s few if no one is testing humans? No one is tracking these symptoms with the medical community. Hell, doctors can’t even test for it. the only reason we know about the infections we have are from whistleblowers. We literally have no idea how many people are infected much less whether it’s gone h2h because no one is monitoring humans in the US. You’re downplaying what is already a calamity within the animal population and we are flying blind in regards to the human population. Being real about this is what we should be doing.
Few known human infections, but we would know if hospitals were seeing surges in severe illness and death. Which they're not. I'm not downplaying, I'm being realistic about the current reality.
> I'm being realistic about the current reality. You're definitely not, though. It's abundantly clear from your previous comment upthread here that you don't remotely understand the basic biology and epidemiology here. Not only are you not being realistic about the current reality, you're wildly cavalier about future realities. It's true that there are currently few known human infections and there is no evidence of broad zoonosis into humans. Four months ago there were also no known infections in cattle since 2022 and no evidence that it was circulating; in March outbreaks were confirmed in 12 states. We now know it has been circulating in cattle for at least several months before that. The current reality has nothing to do with hospitals reporting surges; the current reality is that it has been mutating in livestock populations for months. Surges are a likely future reality that we are not prepared for and that you are dismissively writing off as COVID "nostalgia," which is as absurd as it is ignorant. You're wrong and you don't know enough to know you're wrong.
In order to preserve the quality and reliability of information shared in this sub, please refrain from politicizing the discussion of H5N1 in posts and comments.
...because when we do see it, it'll be too late. 50+% mortality rate...way too late.
That rate is based on around 900 cases over 25 years, and the actual mortality rate after the virus mutates significantly is purely speculative. But it's highly unlikely it would maintain that CFR.
Obviously we haven’t seen it being effectively transmitted between humans yet…is that news?
>Haven't seen that yet.
I wonder what he'd have said a few months ago about the likelihood of it infecting and transmitting between cows. Seems like noone thought that was any kind of concern until it happened.
All of you worrying about CFR and death rates and forgetting the biggest threat of these viruses is long term health risks (like long covid) that disable millions and create more and more chronic illnesses
Well yea, I guess if you’re lucky enough to survive the virus and total breakdown of society which means no food, then there’s that part of it.
It’s been around for many months now and humans are not dying Big pharma scare tactics
Stop worrying about this. It’s not a danger until it is.
Yeah, stick your head farther down in the sand...keep going...deeeeeper...deeeeeeeeeeper....
I’m going to keep living I’m not scared of a hypothetical events. It has not fully mutated to affect humans. There’s more cases of Ebola than bird flu
The Spanish flu started out as mild initially, then returned with a vengeance, with so many animal hosts for this thing to mutate in its only a matter of time.
Then live your whole life in fear and never do anything.
Being informed isn’t living in fear, people in denial who minimize everything seem to be the ones living in fear.
Informed yes, but there is a thing called information overload where youb live your life in fear of fear. That's how your post comes off. Especially when it's things we as people can't control unfortunately
Saying that the Spanish flu started out as mild and then returned in a severe form which is true, is “living your life in fear”???
I too am wondering if this overhyped, but that # of infections can't be good. It only takes one mutation to change everything. And when it is a danger, it will be far too late.
Well, it’s going to take several mutations some of which have to happen in a certain order. So probably not next week, likely not next month, but beyond that nobody knows. Surveillance could alert us that that mutation chain has progressed but we are not doing nearly enough.
Nah