So our fearless health care leader, the guy with the worm in his brain, is going around saying that we should let bird flu run rampant, run its course, kill the susceptible chickens and that way we’ll be left with a national chicken flock that is resistant to bird flu. Is this crazy? Or does it make sense?
On the face of it, letting viruses run their course and letting chickens, other animals, or humans develop natural immunity makes a certain amount of sense. The immune system is quite adaptive – we do develop immunity when faced with infectious diseases, at least eventually, most of the time. There are two components to immunity, and only one part of our immunity results from developing antibodies, which is what vaccines produce in us. Humoral immunity, the kind of immunity we develop after vaccination, isn’t the whole immune story, so it may be, some people think, that vaccination produces a somewhat weaker immunity than natural infections at the end of the day. Maybe. And even though vaccination works pretty well to stop the spread of most infectious disease, when most of the population gets vaccinated.
During Covid, I was very interested in the natural experiment that Sweden tried, which was to let Covid rage and to protect (i.e. cocoon) older adults. I thought it might work, because I was pretty sure we’d develop immunity, and that over three to five years, that this developing immunity would turn Covid into a cold, which is pretty much what it is quickly becoming, although after killing off the weak, old and frail among us, who are at greatest risk when a new virus emerges because their immune systems are relatively weak.
This is where the difference between amateurs and experts actually matters. What our fearless health care leader is proposing seems like it might work, perhaps, if you only read about diseases in books. But Sweden taught me that our public health science and practical experience matters.
You see, letting a disease rage means you are accepting the deaths of many people (or, at least in the current moment, animals) who might not get sick and die if you controlled the outbreak. It is also true that there is no way to control how a virus will evolve when it infects millions of hosts, and sometimes that evolution makes the virus much more lethal over time and increases the number of illnesses and deaths far beyond what you predicted at first.
We blew Covid in the US because we couldn’t agree on how to change our behavior to limit the spread of the disease, and so we lost 900,000 people we didn’t need to lose, the painful outcome of our inability to get along with one another and to value human life more than commerce and a new definition of freedom. (Freedom, in the US, has suddenly become the ability to do whatever the heck each of us wants, and not freedom from tyranny, freedom of speech, freedom to worship, and freedom from fear, which is what I think the founders meant by life, liberty, and the pursuit of happiness.)
Our failure to control Covid was deadly, painful, and embarrassing. What’s worse is that the Swedes blew Covid too. Their natural immunity experiment failed. They had almost as many –two thirds –of deaths we had, per capita, but fifty percent more than some, and three times more than other Scandinavian countries.
So what do I think will happen with bird flu? If we manage it well, I think we’re likely to come through with a fair number of infected birds, with expensive eggs and chicken wings for a while, but then things will settle back to normal in a year or so – and with very few, if any, human infections or deaths. But if we let bird flu rage, say goodbye to eggs for a while, get used to eating eggrolls or nachos instead of chicken wings for a couple of years, and get ready for too many human infections, the sense of fear that exists when a disease is out there spreading — and some, and perhaps many, human deaths.
No one knows for sure, of course. But the precautionary principle in public health says, don’t do something until you know it is safe, because human lives are worth protecting, and human deaths should be avoided. Looking at Sweden during Covid, I think it’s a little crazy to let bird flu rage. We might duck (so to speak) that bullet, but we might not, and I for one would rather bank on proven public health approaches than rolling the dice with an approach that is completely unproven and has just been shown to have failed miserably during the pandemic.
We should control bird flu using time tested and proven public health processes. To let bird flu rage is risky – and crazy.
