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Is a new bird flu the next pandemic?

Is a new bird flu the next pandemic?
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Will the H10N3 bird flu emerging in China, which has now infected and hospitalized a human, lead to the next pandemic? In nature, the answer is almost definitely “no.” But will another pandemic virus originate in China, or somewhere else, where humans and animals have frequent sustained contact conducive to viral species-jumping? The answer is almost definitely “yes.” Could a lab manipulation and/or leak play a role? The answer is, again, “yes.” The culture of fear, deception and cover-up orchestrated by the Chinese government may continue to interfere with knowing the true science before it is too late.

With COVID-19 case numbers dropping across the country, and the numbers of those fully vaccinated or having gained natural immunity from COVID-19 rising, we are not quite out of the woods yet, but we are finally on our way. Naturally, our thoughts turn now back to how this might have happened. Was SARS-CoV-2 being bred or manipulated in a lab and leaked out? If not, where was the intermediary creature that could have precipitated the jump to humans which many scientists have discussed but have so far failed to identify? Why were the National Institutes of Health (NIH) and others foolish or naive enough to be backing research on emerging pathogens in China with the stated purpose of preventing a pandemic, an approach (based on trying to overcome and prevent the suppression during the Severe Acute Respiratory Syndrome, or SARS, outbreak of 2003) that clearly may have backfired.

It is also quite natural now for us to worry about the next pandemic. Are we properly prepared? Will China or another country cover-up information until it's too late? What will the pathogen be? Can "gain of function" research, where a dangerous virus is manipulated to test its potential to kill or go human-to-human easily, be universally banned, or can there be effective safeguards put in place? Pandemic preparedness has always focused to some extent on influenza, not just because of the 1918 Spanish flu that killed at least 50 million people worldwide, but because flu is a highly mutagenic single-stranded RNA virus that originates in birds and populates pigs as a “mixing vessel” of different flu strains before jumping to humans. It is less common for a flu virus from a bird or bird-like creature to adapt directly to a human host, as it apparently occurred in 1918. Now, of course, coronaviruses have been added to the pandemic preparedness list, even if we still lack specific knowledge of how this pandemic started.

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When I was researching my bird flu book in 2006, Dr. David Swayne, top U.S. avian influenza researcher, told me that we were spending too much time worrying about H5N1, which was killing millions of birds (poultry) but would never make an effective jump to humans. It was one thing for a human to occasionally get sick from close contact, but quite another for a virus to mutate sufficiently to pass easily from human-to-human. The "H" in the name stands for hemagglutinin, the protein on the surface of the flu virus that allows it to attach to your cells. Swayne said that H1, H2 and H3 flu viruses are much more conducive to human spread, and history has certainly shown this to be the case. But gain of function research on an H5N1 in 2012 led to an airborne virus that spread from ferret-to-ferret (similar to human spread) and shocked the scientific world, leading to President Obama’s temporary ban of this kind of research.

If left alone, the H10N3 flu virus is very unlikely to cause humans a problem. The H10 is not amenable to it. The key phrase being “if left alone.” 

But some pathogen will cause the next pandemic, and we remain ill-prepared for it. For one thing, we need an immediate international ban on dangerous research on potential pandemic pathogens. With mRNA, viral vector and protein adjuvant technology, we can gear up quickly to fight emerging viruses as they occur. We don’t “gain” much by manipulating viruses to gauge their potential. Nature has erected barriers against this kind of species-jumping for a reason. Instead of manipulating bat coronaviruses to gauge their human potential, instead of possibly helping them overcome their self-repair mechanism in the lab by inducing or selecting out certain mutations, we would be much better off simply studying bats to figure out why they can harbor these viruses without getting sick from them. This could lead to further treatments. 

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, "COVID; the Politics of Fear and the Power of Science."