H5N1 Is Knocking at Our Door. Will We Act Before It’s Too Late?

Last evening, I was at an event with a group of infectious disease leaders and medical experts. As we transitioned from the main course to dessert, the conversation shifted to the moves being made by the new administration, particularly in healthcare and public health. What began as a discussion on regulations quickly turned into a passionate debate about the looming threat of H5N1. Concerns were raised about the virus’s evolution, its spread to dairy cattle, and the alarming possibility of human-to-human transmission. The consensus was clear: if we do not act decisively now, we risk repeating the devastating mistakes of the COVID-19 pandemic.

The Threat Is Evolving. So Why Aren’t We?

The Centers for Disease Control and Prevention (CDC), in an update dated February 26, 2025, confirmed 70 human cases of H5N1 in the U.S. since April 2024, with three new infections in 2025 linked to dairy cattle and poultry. While person-to-person transmission hasn’t been confirmed, two genetic mutations (PB2 D701N and PB2 E627K) detected in infected individuals indicate that the virus is actively adapting to humans.

Virologists, infectious disease experts, and public health professionals warn that H5N1 is now rolling the dice with human adaptation in unprecedented ways. The risk of a full-blown human outbreak is growing. If this virus finds a way to spread efficiently between people, we could face a scenario that rivals or exceeds the impact of COVID-19.

This isn’t just a statistical anomaly. It’s a warning siren.

Déjà Vu: Ignoring the Early Signs Until It’s Too Late

During the early months of COVID-19, the U.S. government ignored clear scientific evidence of the virus’s potential to spread widely. Officials wasted valuable time debating the severity of the situation instead of deploying an aggressive containment strategy. As a Public Health Historian noted, “In January and February 2020, the government had every opportunity to prepare for COVID-19 but failed to act decisively. By the time lockdowns were implemented in March, the virus had already spread far beyond control.”

We are seeing the same slow-motion failure unfold again:

• The government claims the risk to the public is “low” but provides no supporting data or rationale.
• The focus remains on passive monitoring rather than proactive containment.
• Despite urgent warnings from infectious disease experts, policy action remains lukewarm at best.

Despite these warning signs, the government’s response remains sluggish, fragmented, and dangerously complacent.

Five Actions the Government Must Take NOW to Prevent Another Pandemic

The current approach of limited monitoring, voluntary safety measures, and a "wait and see" attitude is a recipe for disaster. We need an immediate, aggressive, and coordinated response before it’s too late.

1. Implement Real-Time Genomic Surveillance on All Detected Cases

The genetic mutations found in Nevada and Wyoming suggest H5N1 is actively trying to cross the species barrier. Yet, we are not sequencing nearly enough cases in infected humans or animals. As one expert put it, "Every single human case must be fully sequenced. Every infected dairy herd must be tested. Every mutation must be tracked in real-time."

The government must mandate a nationwide genomic surveillance program that rapidly sequences all positive cases and flags mutations associated with mammalian adaptation. Without this data, we’re flying blind.

2. Treat This Like a Public Health Emergency, Not a Theoretical Risk

The CDC continues to assert that “the public risk remains low,” but the leading experts at my table strongly disagreed. One specialist stated, "We are in uncharted territory. This is the first time H5N1 has spread so widely in dairy cattle. The risk isn’t ‘low’—it’s evolving. The longer we wait, the greater the chance it jumps to humans in a sustained way."

Risk assessments are fluid, especially with rapidly mutating viruses. In early 2020, COVID-19 was also deemed a low risk—until it wasn’t. The expert consensus is that the White House must declare H5N1 a public health emergency now. This will free up federal funding, trigger emergency vaccine development, and force inter-agency coordination before it's too late.

3. Protect At-Risk Workers Before More Human Cases Appear

Farm and poultry workers are on the front lines of this outbreak. The vast majority of infections so far have been in these groups, yet studies show that only 47% of exposed workers are consistently using protective equipment. One specialist observed, "We’re seeing severe respiratory infections in poultry workers, while dairy workers tend to get conjunctivitis. This suggests different exposure risks, yet protection measures remain inconsistent and optional."

Just as we failed to protect healthcare workers early in COVID-19, we are now failing to protect farm and poultry workers from H5N1. The government must immediately mandate PPE requirements, provide free protective gear, and enforce strict safety standards before more workers fall ill.

4. Aggressively Contain the Virus Before It Spreads Further

The dairy cattle outbreak has expanded the virus’s evolutionary playground in ways never seen before. Yet rather than aggressively culling infected herds and isolating affected farms, the response has been half-hearted at best. As experts stress, "The more time the virus spends in cows, the more chances it has to evolve. We need immediate containment—not ‘enhanced monitoring.’"

The USDA and CDC must work together to enforce strict biosecurity measures, test all commercial herds, and isolate affected farms. Right now, the response to infected farms is slow and reactive. Instead of isolating affected herds and containing outbreaks aggressively, the government is waiting and watching.

“With COVID, we waited too long to stop international spread. This time, we must move aggressively to contain the virus at its source.”

5. Stop Playing Politics. Treat This as a National Security Issue

Public health experts are deeply concerned that political actions and uncertainty within the administration have stalled the response to this threat. One leading expert, in frustration, exclaimed, "The virus isn’t waiting for politicians to get their act together. Pandemic prevention must be nonpartisan and fully funded right away!"

Our lack of action and the distraction caused by wholesale changes across all health services organizations are creating a national and global security risk. Pandemic preparedness isn’t a Republican or Democratic issue—it’s a national security issue. Every delay, every underfunded response, increases the risk of another global catastrophe. The government must maintain and expand pandemic preparedness funding—no matter who is in power.

The Government’s Choice: Act Now or Repeat COVID’s Mistakes

If the government waits too long, it will be too late. We’ve seen this before with COVID-19, SARS, and past flu pandemics. Right now, H5N1 is knocking at the door. It’s spreading. It’s mutating. It’s testing the limits of human infection.

We have two choices:

1. Act boldly, contain the virus in cattle, protect at-risk workers, and aggressively track mutations before it jumps to humans.
2. Do nothing, assume “the risk is low,” wait for sustained human transmission, and then scramble to respond, like we did with COVID-19.

We have a narrow window to stop this before it spirals out of control. Will we learn from past mistakes? Or will we repeat the failures that allowed COVID-19 to ravage the world?

Time is running out. The next pandemic is knocking. Will we answer?