Five Years Later
Sumbul Siddiqui remembers every detail about the morning of March 10, 2020. She remembers feeling anxious as she walked into a Somerville conference room packed with masked-up mayors from around Boston. She remembers grim-looking doctors from Italy appearing on a big screen, describing the horrors of people collapsing and dying from a mysterious respiratory illness.

After that, Siddiqui, then mayor of Cambridge, did what she never imagined she would have to do: She called top city administrators and the school superintendent to begin the process of shutting down every school and municipal building in the state’s fourth-largest city.

“We all left that meeting terrified,” she said. “I remember saying, ‘OK, we have to shut things down. We have to stop the spread. I don’t want people to die.‘”

Five years later, Siddiqui is still torn about the decision. On that same day, Governor Charlie Baker declared a state of emergency in Massachusetts and, within days, suspended in-person learning at public and private schools and banned on-site dining at bars and restaurants across the state.

Knowing what we know now, she wonders, did public officials overreact? Did they adequately consider the trade-offs among competing values, including the devastating costs of closing schools, businesses, and places of worship?

Those questions remain as relevant now as they were in the spring of 2020. As a lethal strain of avian influenza (or H5N1) spreads from birds and mammals to people, the specter of another pandemic looms over the United States. Public health officials and epidemiologists are dissecting the dizzying range of responses to the COVID-19 pandemic — including the stay-at-home orders, school closures, and quarantines — to determine what worked and what didn’t.

A growing number of scientific studies have concluded the measures in the United States did little to slow the rampaging pathogen. What’s more, the stifling of public debate about them eroded trust in public health policy and prevented more effective strategies, according to a number of prominent infectious-disease experts.

While the scientific community is still divided over how effective lockdowns were, those who publicly criticized the measures during the pandemic have gained the political upper hand. Dr. Jay Bhattacharya of Stanford University, who co-authored a manifesto against lockdowns, is President Trump’s nominee to lead the National Institutes of Health, the nation’s largest funder of biomedical research with a $48 billion budget. And Trump’s health secretary, Robert F. Kennedy Jr., has described lockdowns as an attack on the poor and middle class.

“We are long overdue for a reckoning on the lockdowns,” said Stephen Macedo, a political scientist at Princeton University in New Jersey, who co-authored a book due out later this month that calls for a national inquiry into the lockdown measures. “What’s become increasingly clear is that a lot of what we did was irrational and based on fear, and we didn’t think through the profound costs.”

Defenders of lockdown policies have argued that stay-at-home orders were among the few levers in the government’s pandemic toolkit, particularly before mass testing and vaccines were available. And a chorus of studies have found that, early in the pandemic, measures such as shutting schools and banning large gatherings did help suppress the virus’ spread in the short term — saving thousands of lives and preventing many hospitals from being overwhelmed.

“This revisionist history that says, `We could have done without the lockdowns,’ is dangerous,” said Dr. Nahid Bhadelia, founding director of Boston University’s Center on Emerging Infectious Diseases. “You would have faced even more deaths and even more hospitalizations in a shorter period of time, which would have debilitated our health care system.”

But while the impact of lockdown policies is still being studied, new research paints a troubling picture of the immense collateral damage inflicted by them.

The measures increased poverty and wealth disparities, spurred a dramatic rise in adolescent anxiety and depression, contributed to a surge in fatal drug overdoses, and led to devastating learning losses in schoolchildren, who have yet to recover, according to scientific studies. As of last spring, the average American student remained half a grade behind pre-pandemic levels in both math and reading, according to a recent report card on pandemic learning loss.

What’s more, months of unrelenting seclusion caused many people to sever social connections, with lasting consequences to mental and physical health. Both volunteering at nonprofits and church attendance, two measures of social engagement, declined and have not recovered to pre-pandemic levels. In 2023, the nation’s surgeon general warned of an "epidemic of loneliness and isolation" — brought on, in part, by lockdown measures that isolated people.

And that’s not counting the other costs in lost livelihoods, shuttered businesses, and the anguish of seeing relatives die alone without being able to say goodbye.

“The lockdowns were never really effective, and the confusion around them sowed a great deal of public distrust in government,” said Michael Osterholm, an infectious disease expert at the University of Minnesota.

On average, states with Democratic governors had stay-at-home orders that were nearly three times longer than those in red states. Yet many so-called blue states — including California, New York, and New Mexico — had among the highest COVID-19 death rates, measured as a share of their population. And some red states, including Idaho and Utah, had among the lowest, national health data shows, according to an analysis by Macedo and a Princeton colleague, Frances Lee..

Those critical of lockdowns point to sobering data showing that, despite widespread school and business closures, the United States had among the worst mortality rates in the developed world during the pandemic.

To be sure, a wide range of factors — including vaccination rates, population density, air pollution, and the age of the population — can influence differences in COVID-19 mortality rates, researchers note.

Infectious disease experts who are critical of lockdowns point to alternative approaches that would protect public health with less pain should another pandemic arise. These include more stringent testing of workers in nursing homes, more generous sick leave policies for workers, and efforts to expand home care and food deliveries for older people most vulnerable to the virus.

“You couldn’t witness the mass deaths in New York City and Italy and not think that something had to be done,”said Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University School of Public Health. “But tools like shutdowns and school closures are sledgehammers and shouldn’t be part of our toolbox.”

The other problem with lockdowns, say many scientists, is they cannot be sustained indefinitely. And once they are lifted, people start interacting again and infections can spread rapidly. For instance, China’s abrupt decision in December 2022 to end its zero-COVID policy, which included stringent quarantines and lockdowns, led to a massive surge in hospitalizations and deaths in the following two months, according to a 2023 study in the medical journal JAMA.

Osterholm at the University of Minnesota has long recommended what he calls the “snow day approach.” When infections surge, or hospital bed capacity falls to unsafe levels, officials could announce temporary school closures and encourage people to stay home. Then, when the virus subsides, after a few days or weeks, the restrictions would be lifted, he said. People would be more willing to comply, knowing the closures are temporary, he argued.

“In defense of public health [officials], they were trying to manage so many unknowns,” Osterholm said. “It was like trying to perform brain surgery while you’re jumping out of a plane and the parachute wasn’t opening.”

Public officials should also communicate more clearly about the uncertain benefits of any measure during a pandemic, particularly when so much is unknown, public health experts said.

Indeed, in October 2019, the World Health Organization analyzed a range of responses to past pandemics, including the 1918 “Spanish flu,” and recommended against forced quarantines of individuals or populations, saying there was “no obvious rationale” for such measures and they were impractical to implement.

“From the beginning, the evidence to support lockdown policies was very, very poor, and there was a large sentiment within the scientific community that the collateral damage far outweighed the benefits,” Macedo, of Princeton, said.

In the bitterly polarizing climate of 2020, some scientists who spoke out against lockdowns in favor of less-restrictive measures faced a harsh backlash. Some even received death threats.

In one such instance, in October 2020, three medical experts from three renowned universities decided the public discussion about lockdowns had become too one-sided.

The trio — which included Bhattacharya of Stanford, Sunetra Gupta of University of Oxford, and Martin Kulldorff of Harvard Medical School — crafted a short statement opposing the lockdowns, arguing that there was no scientific consensus for school closures and other stringent measures.

“Keeping [lockdown] measures in place until a vaccine is available will cause irreparable damage, with the underprivileged disproportionately harmed,” the trio warned in the statement, which was named the “Great Barrington Declaration,” after the town where it was written in the Berkshires.

Kulldorff said he was not prepared for the visceral response. Within days, he began receiving anonymous death threats via email and accusations that he supported mass murder. Facebook deleted a page set up by the scientists, and Kulldorff’s Twitter account was suspended.

Dr. Francis Collins, the former head of the National Institutes of Health, wrote an email at the time to Dr. Anthony Fauci, then director of the National Institute of Allergy and Infectious Diseases, in which he called for a “quick and devastating published take down” of its premises, according to emails obtained by the American Institute for Economic Research, a free market think tank.

Three years later, Collins said in a public forum that lockdowns caused widespread harm to public health and the Great Barrington Declaration could have been a “great opportunity” for a broad scientific debate about lockdowns. Collins, who recently retired from the NIH, declined to be interviewed.

Fauci did not respond to multiple interview requests.

To the dismay of some public health advocates, there has never been a public reckoning over the lockdown measures.

Robert Moffit, a senior research fellow at the conservative Heritage Foundation, said Congress should appoint a bipartisan commission with subpoena power that would investigate the extent of the harm caused and why alternative points of view were silenced.

“We need to know why all these federal health agencies failed to respond to the latest science on lockdowns,” Moffit asked.

Even some who supported the lockdown measures five years ago are now doubtful they were worth the long-term costs.

Nate Dube, 53, of Dorchester, was initially relieved that schools and businesses were closed. Dube has spinal muscular atrophy, a rare muscle-wasting disease, and is more susceptible to respiratory illnesses. He also lives a block away from a now-shuttered facility, Carney Hospital, that in May 2020 became the nation’s first hospital dedicated to treating COVID-19 patients.

Each day, ambulances carrying infected patients rushed by the window of his apartment in Dorchester.

He recalled being so paranoid about getting infected that he washed down his groceries and was afraid to open his mail.

But as the months of seclusion passed, he ached to see friends and began to miss the sounds of children playing outdoors.

“Early on the lockdowns felt like a lifesaver,” Dube said, “but then they just went on too long.”

Siddiqui, now a Cambridge city councilor, said a key lesson from the pandemic is that public leaders be honest about what they don’t know — and not create false hopes. “We can’t go on pretending like there wasn’t an impact from the lockdowns,” she said. “Even if it’s hard to reflect on it now.”

For an upcoming story to mark the anniversary, the Globe is asking readers to share their memories of moments from the pandemic. If you have any photos, videos, social media posts, or written recollections you’d like to share, please fill out the survey below.

Copyright Boston Globe Media Partners, LLC 2025

There are moments where life is divided into a before and an after. Something so significant occurs that it permanently alters the way you perceive the world and yourself in it.

For many of us, 11 March 2020 is one of those moments. That’s the day that the World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus declared COVID-19 a pandemic.

The stock market plunged, U.S. President Donald Trump banned travel from Europe, and the National Basketball Association (NBA) suspended its season until further notice.

At the same time, security practitioners were working around the clock to put in place measures to protect their employees and organizations. Ahead of the fifth anniversary of the pandemic declaration, Security Management spoke with a range of security and health professionals to understand how the COVID-19 pandemic experience shaped them and what it means for the future of risk management and emergency preparedness.

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COVID-19 put public health officials on the front lines against a once-in-a-lifetime threat. It's left them with less power and resources to respond to future emergencies.

Why it matters: Instead of strengthening America's public health infrastructure, the pandemic experience spawned hundreds of new laws in at least 24 states limiting public health orders or otherwise undercutting emergency responses.

Republicans in Congress have also called for funding cuts to the Centers for Disease Control and Prevention, and the Trump administration and Health and Human Services Secretary Robert F. Kennedy are pivoting to chronic diseases, nutrition and nontraditional cures.
What they're saying: Public health experts say it's all left the system weaker and less prepared for everyday threats — let alone the next big crisis.

"Imagine if we just had a major fire ripping through our city, and our first instinct once we finally put the flames out is to basically get rid of all of our fire departments," said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
"That is essentially what we're seeing happen here."
The big picture: The weakening of public health is evident at every level, from small rural counties up to the highest ranks of the federal government, experts say.

At Donald Trump’s first Cabinet meeting, late last month, Elon Musk sheepishly admitted that DOGE had “accidentally canceled very briefly” Ebola-prevention programs. After a nervous chuckle, he claimed that the oversight had been swiftly corrected. But it wasn’t. The truth is far more disturbing—this administration didn’t just pause a line item; it has actively dismantled the infrastructure the country relies on to detect and confront deadly pathogens.

For more than a decade, I have worked as a physician and public-health expert responding to infectious diseases around the world. In 2014, while treating Ebola patients in Guinea, I contracted and survived Ebola myself. I know how lethal Donald Trump’s assault on America’s outbreak preparedness could be. We are sure to regret it.

DOGE’s slash-and-burn campaign has hit everything from the NIH to the National Weather Service. The cuts to global health, however, are especially alarming. It’s unclear what Musk thought would happen when he fed the U.S. Agency for International Development “into the wood chipper,” as he proclaimed with gleeful indifference on X, the social-media megaphone he owns. Ditto what Trump thought when he withdrew the United States from the World Health Organization and effectively muzzled the CDC. But the result has been that, in little more than a month, America has transformed itself from a preeminent global-health leader into an untrustworthy has-been. Undermining even one of these institutions would have posed a serious threat; gutting them all at once is an invitation for future outbreaks.

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Jennifer Nuzzo has been worrying about the bird flu — since 2004. After all, it’s her job to worry.

An epidemiologist, Nuzzo heads the Pandemic Center at Brown University’s School of Public Health, where she works to strengthen national and local preparedness and response when it comes to infectious disease emergencies.

More than 20 years after she started eyeing the prospect that bird flu (H5N1) could become a pandemic, the U.S. is in the midst of its deadliest outbreak yet among wild and domestic birds.

Panelists at a covid conference last fall were asked to voice their regrets — policies they had supported during the pandemic but had come to see as misguided. Covid contact tracing, one said. Closing schools, another said. Vaccine mandates, a third said.

When Marty Makary’s turn came, the Johns Hopkins University surgeon said, “I can’t think of anything,” adding, “The entire covid policy of three to four years felt like a horror movie I was forced to watch.”

It was a characteristic response for Makary, President Donald Trump’s nominee to lead the Food and Drug Administration, who looks set to be confirmed after a Senate committee hearing on Thursday. A decorated doctor and a brash critic of many of his medical colleagues, Makary drew Trump’s attention during the pandemic with frequent appearances on Fox News shows such as “Tucker Carlson Tonight,” in which he excoriated public health officials over their handling of covid.

Many former FDA officials and scientists with knowledge of the agency are optimistic about Makary — to a degree.

“He’s a world-class surgeon, and he has health policy expertise,” said Jennifer Nuzzo, a Brown University professor of epidemiology and former colleague of Makary’s at Johns Hopkins. “If you have pancreatic cancer, he’s the person you want to operate on you. The university is probably losing a lot of money to not have him doing that work.”

Dr. Elizabeth (Beth) Cameron, Professor, Brown University, and former senior official in global health security and biodefense at the White House and USAID, kindly shares her thoughts on the radical changes unfolding inside the U.S. government surrounding biothreats. Two internal factions within the Trump administration vie with one another. “It’s a bleak picture” in the accumulating damage to the federal workforce, programs, and the protective shield inside and outside our borders. Elon Musk alleges USAID is producing bioweapons, a patent lie. “It’s preposterous” and “dangerous.” More responsibilities will now fall to governors. What to make of the Trump administration’s recent $1B announcement on H5N1 to assist the poultry industry, and its decision to revisit the $590m contract with Moderna for a mRNA human vaccine for H5N1? We don’t know much on what is going to happen in Congress and DOD. And when emergency crises will strike next. Where to find hope? Our civil servants.

Sixty days into 2025, the U.S. had the highest number of measles cases this early into the year in three decades.

Measles has been reported in eight states, with the largest outbreak in Texas, where there have been at least 159 cases and one unvaccinated child has died. The last previous deaths from measles in the U.S. were in 2015 and 2003.

Because of the highly contagious nature of this virus, spotty and falling vaccination rates and the arrival of spring break and recreational travel to areas with measles, there is great potential for measles to spread across the country without aggressive action now to bridge gulfs in preparedness.

Measles is a vaccine-preventable illness that predominantly affects children and adolescents, with a recent hospitalization rate of about 25 to 40 percent. Ten percent of children with measles may have long-term hearing loss, and one in 1,000 will have severe brain inflammation.

A non-vaccinated individual has a 90 percent chance of contracting measles if they are exposed to a contagious individual. Measles is contagious for four days before the rash appears and then for another four days.

For more than 50 years, we have prevented measles and contained viral spread through vaccination and isolation. If an unvaccinated individual is exposed to measles, vaccination within 72 hours can prevent illness and allow the person to go on with their life. Otherwise, the individual needs to isolate for the 21-day incubation period.

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Five years ago, the NBA canceled the rest of its season in response to rapidly rising COVID-19 cases. It was then that people began to take COVID-19 seriously, according to Craig Spencer, associate professor of the practice of health services, policy and practice.

Moderated by Director of the Pandemic Center Jennifer Nuzzo, the School of Public Health and Warren Alpert Medical School co-hosted “The Next Global Pandemic: How ready are we?” on March 5. The event commemorated the five-year anniversary of the COVID-19 pandemic, Nuzzo said in an interview with The Herald.

Panelists included Adam Levine, director of the Center for Global Health Equity and the Center for Human Rights & Humanitarian Studies; Theresa Raimondo ’11, an assistant professor of engineering; Scott Rivkees, associate dean for education and professor in the SPH; and Larry Warner ’97 MPH’13, chief impact and equity officer at United Way of Rhode Island.

The event began with an introduction by Spencer, where he shared his experiences working as an emergency medicine doctor at the start of the pandemic.

“It was like walking into the apocalypse,” he said. “Those initial days were dominated by fear and uncertainty.”

In 2020, Rivkees was Florida’s surgeon general. He described how the rain ditches in Florida’s Emergency Operations Center, where he worked, were built to withstand category five hurricanes, but instead of collecting rainwater, the ditches served a different purpose during the pandemic.

“People would literally leave their post-stations, go out and lie in these ditches and would cry, and then they would dust themselves off, and then would come back and do their job,” Rivkees said.

Although five years have passed since the panelists’ experiences, Nuzzo pointed out the importance of applying lessons learned to the future.

For Warner, the COVID-19 pandemic underscored that addressing these crises goes beyond providing vaccines and medical care.

“We also learned about the importance of addressing social needs and how that impacts people's vulnerability to COVID-19 and our ability to connect to resources,” he said.

Strong public health communication is also crucial according to Warner, who said that “society has not been very forgiving” to public health experts for not having “all the answers up front.”

Pandemic-related misinformation was a key issue with public health communication, panelists said.

Levine explained how COVID-19 data dashboards “made the rich countries look like they had been hit” harder than poorer countries, when in reality, countries with higher GDP just had more COVID-19 tests.

“All babies sleep through the night, if only you turn off the monitor,” Levine said. “If you have zero COVID-19 testing sites, then you have zero COVID cases and zero COVID deaths.”

For the panelists, the COVID-19 pandemic highlighted the relationship between public health and politics.

“If you look over the first 18 months of the pandemic, the biggest risk factor for dying was age,” Rivkees said. “Past 18 months, your biggest risk factor was whether you voted for President Trump.”

Since then, Rivkees said the country has grown “even more polarized.”

Public health PhD student Margaret Dunne GS, who attended the event, agreed with Nuzzo’s point that it is “really important” to reflect on the past to improve the future.

“A million Americans died during the pandemic, and I think it’s on us as public health practitioners and people who care about autonomy that we learn lessons,” Dunne said.

Panelists ended by discussing their predictions for responses to future pandemics.

“COVID is not a one-off,” Nuzzo told The Herald. “It’s behind us, thankfully, but we are going to have to deal with more of these types of events in our future.”

Raimondo took an optimistic stance, pointing out that healthcare professionals have a “much more robust understanding” of advancing vaccines and providing a better “clinical response to patients with different backgrounds” as a result of the pandemic.

But many of the speakers at the event were concerned about government responses to future pandemics, including Nuzzo, who described the current moment as “the luxury of amnesia.”

“We’re at a moment where few people recognize that an outbreak abroad can be an outbreak here, and then there is critical importance in keeping our infrastructure for responding to such outbreaks,” Spencer said. “We are tearing that down actively at this moment, and I promise we will regret it.”

Five years ago next Tuesday, the World Health Organization declared a global pandemic involving a dangerous new virus—and across the planet, life as we knew it ground to a shuddering halt. But the COVID emergency started well before that. Rewind to late December 2019: hospitals in Wuhan, China, were filling up with cases of a mysterious pneumonia. By January 2020, as the body count started to mount and Wuhan was locked down, other countries began reporting cases. The virus spread like an invisible airborne poison through a cruise ship quarantined off the coast of Japan. Italy became a hotspot of infection. One by one, countries and U.S. states issued stay-at-home orders, and major cities went eerily quiet. Within weeks, New York City hospitals filled up with desperately ill people. The dead piled up so quickly that refrigerated trucks were used as temporary morgues.

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A disruption of current HIV/Aids mitigation programmes in southern Africa will lead to decreased access to critical treatments and preventive therapies, which will in turn lead to increased mortality and mother-to-child transmission.

For decades, the United States has been a critical player in supporting the response to HIV/Aids in southern Africa. However, recent shifts in US policy as mandated by executive orders from the second Trump administration threaten to disrupt life-saving humanitarian aid programmes, posing profound danger to pan-African public health and economic stability, in addition to global health security.

Southern Africa has long been the epicentre of the global HIV/Aids pandemic, with Botswana, South Africa and neighbouring countries experiencing some of the highest infection rates in the world – in several cases exceeding 20% of the total adult population.

Botswana, for example, has an adult HIV prevalence rate of about 23% (for reference, any country with HIV infection rates above 1% is determined a Generalized HIV Epidemic per the Joint United Nations Programme on HIV/Aids); South Africa, the most affected country worldwide by case volume, has an estimated 7.7 million people, people living with HIV/Aids, of which 5.9 million are on antiretroviral therapy.

Common-sense, actionable steps to inform individual and collective efforts for schools, nursing homes, defense buildings, and more

One hundred forty-six people in West Texas are currently infected with measles, a highly contagious illness that is avoidable when enough people get the measles vaccine. People are also infected in other states, including New Mexico, Pennsylvania, New Jersey and California.

Vaccination rates in the United States are dropping, which means fewer and fewer people are getting life-saving vaccines and the spread of vaccine-preventable diseases, like measles, are on the rise.

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Ali Khan has been worried about bird flu ever since the H5N1 strain first appeared in China in the mid-1990s, when he was a disease detective at the Centers for Disease Control and Prevention. It spread quickly in China and Hong Kong, mostly through wild birds and poultry, and had all the hallmarks of potentially becoming the next pandemic.

“Despite that,” he said, “it’s been almost 30-odd years, it has not yet become the next pandemic.”

But Khan, who’s now Dean of the University of Nebraska’s College of Public Health, is worrying more about that prospect again now.

“My concern increases when there’s more virus in the community,” he said. “In people, in animals.”

These days there is a lot of the virus, all over the world, again — in birds, pigs, cows, cats, all sorts of wild animals, and in people. H5N1 is now widespread on both poultry and dairy farms in the U.S. More than 166 million chickens and other poultry have been killed in the last few years, the virus has been identified in herds of dairy cows in at least 17 states, and 70 people have tested positive, most of them farm workers.

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Even as this season’s extended flu outbreak continues to rage, experts around the world are turning their attention to next season’s flu shots.

New data from the CDC shows the 2024-2025 flu vaccine reduced doctor’s visits for flu-like symptoms among children and adolescents by up to 60 percent and by up to 54 percent for adults.

But, with the recent cancellation of a key vaccine meeting and the United States announcing its withdrawal from the World Health Organization, some worry that the fall 2025 shots will be delayed or in short supply.

Here’s what goes into manufacturing the annual influenza vaccine and what recent disruptions mean.

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The outbreak of bird flu that began in the United States in 2022 among wild birds and poultry has since spread to dairy cattle, at least one pig, a growing number of people — and even cats.

“We're dealing with, by all definitions, an endemic disease now,” Maurice Pitesky, DVM, MPVM, BMEA, a faculty member at the University of California, Davis School of Veterinary Medicine-Cooperative Extension, told Healio.

In interviews, Pitesky and other experts described the bird flu outbreak as smoldering, still mostly a threat to animals, but more likely to pose a larger danger to humans the longer it sticks around and the less engaged the U.S. becomes in global public health. (The CDC continues to rate the risk that bird flu poses to the general public to be low.)

“The procedures that we’ve used to eradicate the virus have been somewhat futile,” Pitesky said. “We’re dealing with a virus that is ubiquitous in the environment. We knew that several months ago. We’re now at a point where we just haven’t acknowledged that, and that really has kind of stifled our response.”

‘Fortunately,’ most cases have been mild
According to the CDC, around 12,000 wild birds, 166 million poultry and 976 dairy herds have been affected by the virus at the center of the outbreak, highly pathogenic avian influenza A(H5N1). Various other animals have been infected, including zoo animals in several states. Spread among commercial poultry and dairy cattle has had implications for egg and milk supplies.

The first human H5N1 case in the U.S. was reported in April 2022 — 2 months after the virus was detected among turkeys in a commercial poultry facility, according to the CDC.

Two years later, in April 2024, the second reported human case — and first linked to dairy cattle — was reported in a dairy worker in Texas in what was believed to be the first instance of mammal-to-human transmission.

There have now been 70 reported human cases, according to the CDC. Unlike some past outbreaks of the virus, most U.S. cases have been mild, but there has been one death: a 65-year-old patient in Louisiana with underlying medical conditions who had contact with sick and dead birds in a backyard flock.

“We are very fortunate that the current strains of bird flu circulating do not appear to cause severe illness in most individuals,” Amira A. Roess, PhD, MPH, professor of global health and epidemiology at George Mason University, told Healio. “However, as the first bird flu death in Louisiana illustrates, those who are immunocompromised are the most vulnerable.”

For now, Roess said, most healthy people do not have to be very concerned about bird flu. But she noted that immunocompromised people, older adults and infants are at a greater risk for severe illness.

The CDC lists poultry and dairy workers, owners of backyard flocks, and veterinary staff as being among the people most at risk for infection.

“There have been a handful of cases who have gotten sick and we don't know how they got it, but the majority of cases are in people who have worked with or been exposed to sick animals,” Jennifer B. Nuzzo, DrPH, director of the Pandemic Center at Brown University School of Public Health, told Healio. “That alone is enough to make me worry, because this is historically a deadly virus.”

It is unclear why there have not been more severe illnesses among the U.S. cases, Nuzzo said. Past outbreaks of H5N1 have had significant mortality rates. Six of 18 patients — all children — died in the first human H5N1 outbreak in Hong Kong in 1997. Outbreaks in Thailand and Vietnam had mortality rates of 67% or higher, according to a summary published in Emerging Infectious Diseases in 2004.

“Fortunately, the majority of recent cases have had mild symptoms, [but] I see nothing about this virus that makes me not worried that future cases won't be severe,” Nuzzo said.

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In a Cabinet meeting, Elon Musk defended the actions his team has made to cut government jobs, but public health experts say Musk is wrong. USAID's Ebola prevention efforts have been largely frozen since the agency was mostly shuttered last month. Laura Barrón-López discussed more with Dr. Craig Spencer, who survived Ebola after treating patients in Guinea with Doctors Without Borders in 2014.

Dr. Michael Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota and Dr. Craig Spencer, Brown University School of Public Health Associate Professor join Nicolle Wallace on Deadline White House to discuss the impact that the reckless cuts that Elon Musk has led on government spending have caused global concerns about this countries ability to help combat a public health crisis, as it has done for decades.

Speaking at President Trump's cabinet meeting on Wednesday, Elon Musk spoke bluntly about his work with the Department of Government Efficiency (DOGE).

"We will make mistakes. We won't be perfect," he said. "When we make mistakes, we'll fix it very quickly. So, for example, with USAID, one of the things we accidentally canceled very briefly was Ebola prevention."

USAID is the U.S. Agency for International Development, which has largely been dismantled by the Trump administration.

"We restored the Ebola prevention immediately — and there was no interruption," Musk continued.

In past Ebola outbreaks — such as when the infectious viral disease swept through much of West Africa in 2014 and 2016 — the U.S. has played a significant role in helping countries respond. They've provided expert advice as well as funds for efforts to control the spread of the virus — for example, helping pay for the secure transportation of suspected Ebola specimens from clinics to labs for testing and for exit screening at airports, where people leaving the country are checked to make sure they are not infected with Ebola.

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Elon Musk on Wednesday acknowledged that the U.S. DOGE Service "accidentally canceled" efforts by the U.S. Agency for International Development to prevent the spread of Ebola — but the billionaire entrepreneur insisted that the initiative was quickly restored.

"We will make mistakes. We won't be perfect. But when we make a mistake, we'll fix it very quickly," Musk said at a meeting of President Donald Trump's Cabinet officials, defending his group's fast-moving approach to canceling federal programs in a bid for cost savings. "So we restored the Ebola prevention immediately. And there was no interruption."

Yet current and former USAID officials said that Musk was wrong: USAID's Ebola prevention efforts have been largely halted since Musk and his DOGE allies moved last month to gut the global-assistance agency and freeze its outgoing payments, they said. The teams and contractors that would be deployed to fight an Ebola outbreak have been dismantled, they added. While the Trump administration issued a waiver to allow USAID to respond to an Ebola outbreak in Uganda last month, partner organizations were not promptly paid for their work, and USAID's own efforts were sharply curtailed compared to past efforts to fight Ebola outbreaks.

"There have been no efforts to 'turn on' anything in prevention" of Ebola and other diseases, said Nidhi Bouri, who served as a senior USAID official during the Biden administration and oversaw the agency's response to health-care outbreaks.

Last month's Ebola outbreak has now receded, but some former U.S. officials say that's in part because of past investments in prevention efforts that helped position Uganda to respond — and that other countries remain far more vulnerable.

Bouri said her former USAID team of 60 people working on disease-response had been cut to about six staffers as of earlier this week. She called the recent USAID response to Uganda's Ebola outbreak a "one-off," far diminished from "the full suite" of activities that the agency historically would mount, such as ramping up efforts to monitor whether the disease had spread to neighboring countries.

"The full spectrum — the investments in disease surveillance, the investments in what we mobilize … moving commodities, supporting lab workers — that capacity is now a tenth of what it was," Bouri said.

Other current and former USAID officials, speaking on the condition of anonymity to discuss internal operations, agreed with Bouri's assessment.

"There was a waiver for Ebola, but USAID funds have never been back online," said a current official. "USAID has been frozen: \staff and money."

"If there was a need to respond to Ebola, it would be a disaster assistance response team, or DART," said one former official. "There is no longer a capability to send a DART or support one from Washington. Many of those people are contractors who were let go at the very beginning."

The White House declined to comment on whether USAID's Ebola-response efforts had been fully restored.

"Uganda's Ebola outbreak occurred on the same day as the foreign aid freeze. Despite that, the waiver for assistance in addressing the outbreak was quickly reinstated," an administration official said in a statement.

The dustup over Ebola prevention represents the latest flash point as Democrats, current and former federal officials and others warn of the harms of DOGE's "move fast and break things" approach. A federal judge has repeatedly told the Trump administration to restore USAID funds, setting a deadline of Wednesday night to get money out the door again. Some Trump political officials have also grown weary of DOGE's approach, saying that the group's moves have created additional headaches for Cabinet departments.

Musk has defended his team's approach as a necessary strategy to overcome bureaucratic inertia and cut government spending.

"We do need to move quickly if we are to achieve a trillion-dollar deficit reduction in financial year 2026," Musk said Wednesday, as the entrepreneur addressed agency leaders. But he also acknowledged the need to preserve ongoing public health efforts. "I think we all want Ebola prevention," Musk said.

Ebola is a severe and often fatal virus that can cause fever, vomiting and internal and external bleeding, alarming global health leaders who have worked to contain several recent outbreaks. More than 11,000 people died in an Ebola epidemic in West Africa that began in 2014 and eventually spread to the United States. Symptoms and complications in survivors can also linger for months.

Public health experts said that there are risks in moving too quickly to dismantle the federal teams and programs fighting disease around the world, citing a mystery illness that has killed more than 50 people and is currently spreading in the Democratic Republic of Congo. They also warned that the Trump administration is broadly weakening the nation's public health infrastructure domestically as well, citing initiatives that target funds and programs at the Centers for Disease Control and Prevention, the National Institutes of Health and other health agencies.

"U.S. investments in foreign aid, CDC surveillance and global health programs and in NIH-funded research are the front-line defense for the American public," said Paul Friedrichs, who oversaw the Biden administration's pandemic-preparedness efforts. "They also benefit people worldwide by reducing the risk of spread of a lethal disease like Ebola."

Beth Cameron, a senior adviser to the Pandemic Center at the Brown University School of Public Health, described the Trump administration's recent actions as "a double whammy" to global efforts to prevent Ebola, saying that USAID's "critical" functions to stop outbreaks abroad had been frozen or gutted.

"We have the programs and the people who were working on Ebola and other deadly-disease prevention capacity in other countries not able to do their jobs because their work is frozen, and many of the people have been put on administrative leave," said Cameron, who worked on biosecurity efforts in the Bush, Obama, Trump and Biden administrations. "And we have a response that is, at best, less efficient, because the implementers are not able to get reliably paid."

Jeremy Konyndyk, who oversaw USAID's Ebola prevention efforts during the Obama administration, said he interpreted Musk's comments and the administration's recent Ebola efforts in the context of mounting criticism that DOGE had moved too quickly to cut public health efforts.

The Ebola response mounted by the Trump administration in Uganda was "more symbolic than substantive," Konyndyk said. "They know there's a political vulnerability."

Copyright WP Company LLC d/b/a The Washington Post Feb 26, 2025

Soaring egg prices have consumers boiling, and on Wednesday, the United States Department of Agriculture blamed rising costs on the bird flu epidemic and said it will take new steps to quell the outbreak.

The new plan appears to have refocused the department’s efforts around the goal of lowering egg prices. Speaking to reporters at the White House, Agriculture Secretary Brooke Rollins said it could take a few months for egg prices to drop.

“We are seeing probably even a little bit more increase up until Easter,” Rollins told CNN, but stated that was normal,“ because so many eggs are used around Easter.”

“It’s going to take a little while to get through, I think the next month or two, but hopefully by summer.”

In a new op-ed published in the Wall Street Journal on Wednesday and a press release issued later in the day, Rollins outlined the new five-pronged approach, which will focus on increasing biosecurity on egg-laying farms and helping farmers who have lost flocks recover more quickly. She said USDA may temporarily allow imports of eggs to expand supply.

Rollins said USDA was also exploring the use of vaccines and therapeutics in chickens to cut down on culling of birds, but the agency has not yet authorized any for use.

“To every family struggling to buy eggs: We hear you, we’re fighting for you, and help is on the way,” Rollins wrote.

Elon Musk, Donald Trump's top campaign contributor, made a lighthearted joke about his federal workforce cuts damaging the U.S. ability to guard against an Ebola outbreak. Despite Musk's assurances that any damage done was quickly remedied, experts insist the cuts continue to leave the U.S. unprepared. Dr. Craig Spencer, an emergency room doctor and Ebola survivor, talks with Rachel Maddow about what Musk's cut have really done.

As egg prices in the U.S. reach record highs, some individuals are trying to slip their eggs across the border.

U.S. Customs and Border Patrol agents in El Paso, Texas have encountered more than 90 people trying to bring eggs from Mexico across the U.S. border since January, a CBP news release said Friday. The agency doled out 16 civil penalties amounting to nearly $4,000 in fines.

The rate of attempts to illegally bring eggs across the border has escalated in the past year. Between October 2024 and February 2025, the number of eggs detained at U.S. ports of entry was 29% higher than it was in the period the year before, a CBP spokesperson told Fortune.

The hike in egg smuggling rates coincides with U.S. egg prices reaching record highs last month—costing $4.95 for a dozen large Grade A eggs compared to the record $4.82 set the year before—as bird flu rips through American poultry farms. Since 2022, more than 166,000 flocks and 1,000 dairy cow herds have been affected by the H5N1 avian flu, according to the Centers of Disease Control and Prevention. As a result, more than 23 million egg-laying hens were slaughtered last month alone.

The weakened supply of eggs combined with sustained demand has not only driven up prices, but also forced some restaurants to implement surcharges on the breakfast staple. Some grocery stores are setting limits on how many eggs customers can purchase or selling them in smaller quantities like “loosie” cigarettes.

The U.S. has generally banned the import of fresh or raw eggs because of concern over avian influenza, according to CBP. Travelers are also prohibited from bringing live birds or raw poultry across the U.S. border. While most of border control’s confiscations come from travelers who declared bringing in the poultry products and were therefore not punished, some who don’t declare and are found with banned items can be fined.

How the Trump administration is addressing bird flu
Despite President Donald Trump’s promise to bring down prices on “day one” of his second term, the cost of eggs is likely not going to fall anytime soon.

Instead, public-health experts are concerned the administration’s mass firings and bureaucratic overhaul may have jeopardized efforts to stop the spread of H5N1 in American farms. Last week, the U.S. Department of Agriculture scrambled to rehire employees working to address the spread of bird flu it had fired the weekend before. The Trump administration also temporarily halted the CDC and USDA from holding Congressional briefings, meeting with state officials, or receiving internal reports, according to multiple reports.

Government organizations like the USDA are the country’s primary means of disease surveillance and are crucial in containing animal-borne diseases, according to Jennifer Nuzzo, director of the pandemic center at the Brown University School of Public Health, who spoke to Fortune earlier this month.

“Everybody knows about the price of eggs. Everybody knows how hard it is to even find eggs in the grocery store,” Nuzzo said. “Understanding how H5N1 is affecting animal populations is essential for protecting our agricultural interests.”

While historically the U.S. has turned to “depopulation” efforts, or the mass culling of flocks, to stop bird flu spread, it may finally be changing its strategy. The USDA approved a conditional license for an H5N2 bird flu vaccine that would also combat the H5N1 variant of the disease. The vaccine has not yet been approved for commercial use.

As a short-term solution, the Trump administration has enlisted the help of Turkey, which will export 420 million eggs to the U.S. this year. However, the assistance may not prove useful in addressing the egg crisis at its source.

“While this is enough to offset some production losses,” Bernt Nelson, an economist at the American Farm Bureau Federation, told CNN, “it won’t provide much support if [the bird flu] continues at its current pace.”

Thousands of federal health workers — including disease experts, medical researchers and grant administrators — were fired as the Department of Government Efficiency looks to make federal budget cuts. Jennifer Nuzzo, director of Brown University's Pandemic Center, discusses how the cuts have created chaos within health agencies and how it may affect their work.

Excerpt: “If these actions continue, they could have deadly consequences,” said Dr. Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health.

But the study, whose publication was delayed by a pause in public communications by the agency, leaves key questions unanswered.

Two dairy workers in Michigan may have transmitted bird flu to their pet cats last May, suggests a new study published on Thursday by the Centers for Disease Control and Prevention.

In one household, infected cats may also have passed the virus to other people in the home, but limited evidence makes it difficult to ascertain the possibility.

The results are from a study that was scheduled to be published in January but was delayed by the Trump administration’s pause on communications from the C.D.C.

A single data table from the new report briefly appeared online two weeks ago in a paper on the wildfires in California, then quickly disappeared. That odd incident prompted calls from public health experts for the study’s release.

The new paper still leaves major questions unanswered, including how the cats first became infected and whether farmworkers spread the virus to the cats and to other people in the household, experts said.

“I don’t think we can say for sure if this is human-to-cat or cat-to-human or cat-from-something-else,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.

Officials in Michigan began investigating two households last May when exclusively indoor cats showed respiratory and neurological symptoms and, after death, tested positive for the virus, called H5N1. The officials interviewed the cats’ owners and household members and offered to test them for the virus.

The owners of both cats were dairy workers. The first farmworker did not work with cows directly, and the farm was not known to have infected herds. But the worker reported that many of the barn cats on the farm’s premises recently died. The worker also reported having experienced vomiting and diarrhea before the first household cat became ill.

The second farmworker reported being splashed in the face and eyes with milk and experiencing eye irritation. Both workers declined to be tested.

“This study provides yet more concerning evidence that farmworkers with high-risk exposures may refuse testing,” Dr. Nuzzo said.

“In order to protect people and stay ahead of this virus, we need to remove disincentives for patients to get tested,” she added. “People should not fear that testing positive will cause financial distress or other personal harms.”

In the household of the first farmworker, the first cat to become ill showed decreased appetite, lack of grooming, abnormal gait and lethargy, and quickly deteriorated. She was euthanized on the fourth day of illness.

A second cat in the household developed watery eye discharge, rapid breathing and decreased appetite four days after the first cat became ill. This cat recovered and was not tested for the virus. A third cat had no symptoms and tested negative for the virus 11 days after the first cat became ill.

Neither the cats nor the humans in the household drank unpasteurized milk. How the cats might have become infected is unclear, but experts said that the farmworkers were likely to have become infected with H5N1 at their workplace and to have brought the virus home to their cats.

“If you love your cat, you probably give it head kisses if it lets you,” said Kristen K. Coleman, an infectious disease researcher at the University of Maryland.

Three people in the household — an adult and two adolescents — tested negative for H5N1. Six days after the first cat became sick, one of the adolescents became ill with a cough, sore throat and body aches, and the other reported a cough that was attributed to allergies.

But because the adolescents were tested late — 11 days after the first cat became sick — it was not impossible that they became infected with H5N1 that they picked up from the cats, Dr. Coleman said.

Later in May, a pet cat in the second household developed severe neurological symptoms, including anorexia and minimal movement, and died within a day; the cat tested positive for bird flu after its death.

The cat’s owner transported unpasteurized milk, including from farms with known bird flu outbreaks. According to the study, the owner “did not wear personal protective equipment (PPE) while handling raw milk; reported frequent milk splash exposures to the face, eyes and clothing; and did not remove work clothing before entering the home when returning from work.”

The cat that became ill was known to “roll in the owner’s work clothes,” the study noted.

Virus in raw milk splattered on those clothes may be the source of infection in the cat, said Dr. Keith Poulsen, the director of the Wisconsin Veterinary Diagnostic Laboratory.

“At this point, I think the higher risk is their exposure from raw dairy products,” he said. “There’s so much virus in the milk.”

Of 24 veterinary staff members who were potentially exposed to the infected cats, seven reported symptoms such as nasal congestion and headache. Only five agreed to testing; all were negative.

Dr. Coleman recommended that veterinarians remain alert to the possibility of bird flu infections when they see sick cats. “Pet owners should not have to rely on postmortem sampling to get a diagnosis,” she said.

Copyright 2025 The New York Times Company

The Trump administration’s efforts to impose its will on the federal workforce through mass firings, funding freezes and communication blackouts is hampering the ability of public health professionals to respond to the growing threat of avian flu.

As egg prices continue to rise and more cases are detected, state and local health officials say there is no clear plan of action from the administration. Dozens of people in the U.S. have also contracted the disease, with the Centers for Disease Control and Prevention (CDC) reporting the first human death from H5N1 last month.

When President Trump took office, his administration instituted an external communications blackout across health agencies. State and local health departments are only just beginning to hear from officials at the CDC, nearly a month after the inauguration.

Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials, said officials heard a “short update” from CDC on the avian flu virus last week.

“It’s absolutely critical that local health departments and the federal government are in communication, because both sides have something to add to the conversation to make sure we have the best evidence to move forward,” Casalotti said.

Public health experts were critical of the Biden administration for not being proactive enough in its virus response and failing to take action to stop the spread of the virus among dairy cattle after it was first detected last year.

But Casalotti said local officials under former President Biden at least knew where the federal government was targeting its efforts and what its priorities were. If they had a specific question or specific issue that was going on in their area, they knew who to call. Until very recently with Trump, nobody answered the phone.

A person familiar with the situation said the administration is still slow-walking critical updates, and any communication that does occur isn’t happening in a timely enough fashion.

“Everything is much more formal, much more scripted, much less real-time,” which is impacting situational awareness, the person said. Viruses don’t care about borders, “so I think that is really where the danger lies.”

The U.S. Department of Agriculture said Tuesday that it accidentally fired “several” agency employees over the weekend who are involved in the federal avian flu response, and the agency said it was now trying to quickly reverse the firings.

Local public health departments are continuing their work to identify instances of viral spread, but it’s made more difficult without timely updates from CDC about the national picture.

For instance, Wyoming this week confirmed its first case of the H5N1 avian flu virus in a human, but other jurisdictions learned about it through a Wyoming health department press release instead of being informed by CDC, according to a person familiar with the matter.

“The responsibility for the protection of public health begins and ends with state and local health departments, but they are absolutely dependent on CDC and [the Health and Human Services Department] and other agencies to kind of aggregate information about what’s happening, not only in the United States, but what’s happening in other parts of the world,” said Jennifer Nuzzo, an epidemiologist and director of the pandemic center at the Brown University School of Public Health.

Yet the Trump administration has also stopped reporting flu data to the World Health Organization.

“These are creating blind spots for us, and the more blind spots we create, the harder it is to see the path forward,” Nuzzo said. “When you reduce the frequency or obstruct the delivery of certain data, it just makes it harder to know what’s going on and to know what to do about it, until it becomes blindingly obvious that we have a problem.”

Meanwhile, a federal funding freeze has left virus researchers in a state of confusion, wondering whether their work will continue.

Infectious disease experts are also concerned that public health labs, which rely on federal funding, won’t be able handle any increase in testing capacity if the widespread freeze continues. They have called for greatly expanded testing to better understand the virus.

“All those pieces kind of add to the general feeling of uncertainty,” Casalotti said. “There are many things in public health that are uncertain, and so when you when you add additional layers to that, it becomes really hard for a health department to plan, to be really efficient in their work.”

The confusion comes as more cases continue to be detected in cattle, birds and even humans.

The human case in Wyoming was linked to a backyard flock, with the woman hospitalized in another state. At the same time, a person in Ohio who was confirmed to have a bird flu infection was also hospitalized.

The CDC doesn’t have a confirmed director yet, though the secretaries of Health and Human Services (HHS) and Agriculture, who are central to a pandemic response, were confirmed last week.

Agriculture Secretary Brooke Rollins told reporters last week her very first briefing was on avian flu.

“We are looking at every possible scenario to ensure that we are doing everything we can in a safe, secure manner, but also to ensure that Americans have the food that they need. And as a mom of four teenagers, actually, I fully understand and feel the pain of the cost of these eggs,” Rollins said.

The average price of a dozen Grade A eggs in U.S. cities hit $4.95 in January, up from about $2 in August 2023. The Agriculture Department predicts prices will soar another 20 percent this year.

Trump blamed the inflation of egg prices on Biden in remarks to reporters this week.

“Well, there’s a flu,” he said. “Remember I’ve been here for three weeks. And when you saw the inflation numbers, I’ve been here for three weeks, I have had nothing to do with inflation. This was caused by Biden.”

...

The U.S. Department of Agriculture fired several personnel responsible for working to stop the spread of the H5N1 avian flu over the weekend. The agency is now trying to find and rehire those workers. The bird flu has affected more than 160 million birds nationally since 2022, contributing to rocketing egg prices and the endangerment of farm workers.
The U.S. Department of Agriculture is working to rehire employees it fired over the weekend, many of whom were part of the federal government’s efforts to stop the spread of the virulent H5N1 avian flu that has killed millions of livestock and contributed to sky-high egg prices.

“Although several positions supporting [bird flu efforts] were notified of their terminations over the weekend, we are working to swiftly rectify the situation and rescind those letters,” a USDA spokesperson told Fortune in a statement. “USDA’s Food Safety and Inspection Service frontline positions are considered public safety positions, and we are continuing to hire the workforce necessary to ensure the safety and adequate supply of food to fulfill our statutory mission.”

The spokesperson said job categories within the USDA, such as veterinarians and emergency response personnel, were exempted from the sackings.

The H5N1 avian flu has wrought havoc on U.S. agriculture. More than 162 million birds and nearly 1,000 dairy cow herds in the U.S. have been affected by the avian flu since 2022, according to the Centers for Disease Control and Prevention and USDA, which has contributed to about 20 million deaths of egg-laying hens in the last quarter of 2024 alone.

About 70 people in the U.S. have contracted the disease since the 2022 outbreak; the CDC reported the first human death from H5N1 last month.

The elimination of key USDA positions is part of an effort by President Donald Trump and the Department of Government Efficiency to cull thousands of government positions in an effort to overhaul bureaucracy and curb federal spending. Some USDA employees, including those from the National Animal Health Laboratory Network program office overseeing the response to animal-borne disease outbreaks, were notified Friday their jobs would be eliminated, Politico reported.

“They’re the front line of surveillance for the entire outbreak,” Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, told Politico. “They’re already underwater and they are constantly short-staffed, so if you take all the probationary staff out, you’ll take out the capacity to do the work.”

Consequences of federal workplace uncertainty
The USDA is the country’s first line of defense in understanding and combating the avian flu because of its access to the farms battling the brunt of the virus’s consequences, according to Jennifer Nuzzo, director of the pandemic center at the Brown University School of Public Health. The agency’s surveillance efforts of farms, such as bulk testing raw milk for disease, is the primary means of gathering information about the virus and its spread.

Beyond staff shortages siphoning resources from that work, the anxiety around sweeping personnel changes alone may prevent USDA employees from focusing on constraining the virus.

“With this changing policy environment and the uncertainty about all of the personnel, government worker personnel issues, agencies are spending a lot of their time just trying to navigate that highly chaotic and uncertain situation,” Nuzzo told Fortune, “which I believe is interfering with their abilities to fulfill their statutory missions.”

Besides firing thousands of public health workers, the Trump administration has also hampered response to the bird flu outbreak, with the CDC and USDA unable to hold congressional briefings, meet with state officials, or receive internal reports, according to multiple reports.

The White House did not immediately respond to Fortune’s request for comment.

...

Last month, Brown University Health announced a mask mandate requiring all staff, patients and visitors to wear either Level 2 or N95 surgical masks amid “very high” levels of respiratory illness.

Mask mandates were initially implemented across Brown Health’s medical facilities, which include Rhode Island Hospital, Hasbro Children’s Hospital and Miriam Hospital, among others. In the ensuing days, at least four other hospitals across the state followed suit.

A Brown Health statement attributed the mandate to “rising community respiratory virus rates, an increase in hospital admissions due to respiratory viral infections, wastewater COVID levels and incidence of employee respiratory viral illnesses.”

Since October, the state has seen approximately 900 flu hospitalizations, with 191 of those occurring in the first week of February alone.

Earlier this month, the Rhode Island Department of Health reported that there have been seven flu-related deaths since September 2024, as of Feb. 1.

According to RIDOH’s website, COVID-19 and RSV activity have both declined in the past three weeks. But flu activity has steadily increased and now makes up 5.1% of emergency room visits in R.I.

For the first time since the 2017-2018 season, this flu season is considered “high severity” for all age groups across the country, according to the Centers for Disease Control and Prevention.

Brown Health and Care New England also implemented universal mask mandates during last year’s flu season.

Leonard Mermel, a professor of medicine at the Warren Alpert Medical School and the medical director of Brown Health’s Department of Epidemiology and Infection Control, stressed the importance of disease prevention measures like masking and vaccination among young people.

Mermel was “intimately involved” with Brown Health’s decision to implement the mask mandate, he said, adding that masking has been “unequivocally proven to reduce transmission.”

He emphasized that immunocompromised groups, such as elderly or people undergoing cancer treatment, are particularly vulnerable to infectious diseases.

“It’s not just about us, it’s also about the health of the people around (us). That’s the whole basis of public health,” Mermel said.

Masks are no longer as readily available as they were during the COVID-19 pandemic, wrote William Goedel PhD ’20, an assistant professor of epidemiology, wrote in an email to The Herald.

Goedel described the discourse around health mandates as “polarized,” noting that many people remain skeptical that “masks can be helpful.” This polarization can complicate the implementation of public health policy, he added.

Mermel has not observed any notable pushback against Brown Health’s mask mandate, he said.

“Mask mandates are one tool for enforcing mask wearing, but it is also important that we rebuild trust in public health so that people view mask wearing more positively,” Goedel said.

The Trump administration’s new approach to communicating health and medical data has left a hazy picture of the country’s fight against bird flu and has complicated the relationship between the federal health bureaucracy and state agencies.

While some state health officials told NOTUS they’ve continued to get what they need from the Centers for Disease Control and Prevention, other officials and outside experts say they’re worried about what they’re not being told and how that could be hampering the urgent push against H5N1.

But at least some of the dysfunction of the federal health agencies has trickled down to the states that have had human infections, say some pandemic experts and health officials — making responding to the ongoing H5N1 outbreak that much harder.

Washington state epidemiologist Scott Lindquist said it’s been difficult for state health officials to understand the scope of the outbreak. “Normally, we would be having pretty regular updates, but I’ve seen one health alert come out last week,” he said on Feb. 13.

Alabama medical officer Burnestine Taylor said that they have had “absolutely no communications” from the federal health agencies recently.

“We’re basically just kind of continuing with the groundwork that was laid before the halt in communication,” Taylor said. “We’re carrying on and doing what we had planned to do, but we no longer have direct communication with them.”

But other states said that their work coordinating public health operations with the CDC hasn’t been interrupted in any meaningful way.

“We appear to be working very seamlessly, particularly even through this new administration change,” said Jae Williams, a spokesperson for the Florida Department of Health. “They’re still getting things situated up in D.C., but it hasn’t slowed down our operations at all.”

H5N1, also known as avian influenza or bird flu, has been circulating in U.S. poultry and cattle since early last year. Upwards of 60 human infections occurred in the U.S. and Canada last fall. Cases occurred mostly in workers on dairy farms — though several people were infected who had no known contact with livestock or birds. One person with underlying health conditions died in Louisiana late last year.

The scope of the outbreak in humans has continued to expand in 2025: Ohio announced its first human H5N1 case last week, joining Washington, Oregon, California, Nevada, Colorado, Texas, Louisiana, Iowa, Missouri, Wisconsin and Michigan as states that have seen infections in humans. While state agriculture departments and the U.S. Department of Agriculture have taken the lead in responding to the H5N1 outbreak in animals, the CDC has played a critical role in tracking human cases and issuing guidance to researchers and epidemiologists tracking the outbreak.

All that came to a thudding halt after Trump issued an executive order freezing communication from the federal health agencies. While some communication appears to have been restored, scientists say what they’ve heard from the CDC still seems to be limited.

“It’s really alarming, the lack of communication about H5N1,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “I have to assume that we haven’t heard big developments because big developments haven’t happened, but we also haven’t heard information about what’s ongoing to make sure big developments aren’t happening.”

A spokesperson for the Massachusetts Department of Public Health said in an email that they have seen very limited outreach from the CDC since the change in administration. They added that the CDC held only one national call, which covered multiple public health topics and was too large to permit useful question and answer periods. Communications between the U.S. Department of Agriculture and state agriculture agencies have apparently been less affected, said the spokesperson.

Reports that the CDC withheld multiple issues of a key weekly report for the first time since the 1960s — and that the withheld reports were about H5N1 — is a sign that things are deeply unwell at the CDC, said Nuzzo.

“It’s really puzzling to me why we’re not releasing information that is essential to understand what risk this virus poses to people and how best to protect them,” Nuzzo said.

KFF Health News recently found that a CDC report on record-high seasonal flu levels had been delayed for release, and that the Advisory Committee to the Director of the CDC wrote to acting CDC Director Susan Monarez asking her to explain the delay.

But some state health officials said that the pause in communications either wasn’t noticeable or didn’t impact their day-to-day activities at all.

“There has been no substantial change in communication with the Federal government,” a spokesperson for the New York health commissioner, Danielle De Souza, said in an email. And a spokesperson for the Nevada Department of Health and Human Services said that “the CDC has been a responsive partner and has been in communication and collaboration with DHHS throughout the response.”

A spokesperson for the South Carolina Department of Public Health said in an email that communications about H5N1 occur between state and federal health officials at least weekly “during regularly scheduled calls, but also on an as-needed basis via calls or emails.” And Oklahoma State Epidemiologist Jolianne Stone said that while they often rely on other states or other public health partners for guidance on outbreaks like H5N1, they have had “communication with CDC technical support and with CDC if needed.”

State health departments are responsible for a broad range of disease response efforts for outbreaks like H5N1. These can range from giving personal protective equipment to farms, to outreach and education for high-risk populations or testing exposed individuals for infections and monitoring them for symptoms. States often make decisions on how best to respond to outbreaks based on the guidance and data the CDC issues.

Lindquist said that while he has still been able to get in touch with individual subject matter experts at the CDC, he’s concerned that the data consolidation and guidance that the CDC does for the states has been impacted by the communications freeze. The last update to the CDC Health Alert Network related to H5N1 was released on Jan. 16 and issued guidance for testing some influenza patients for H5N1.

....

As avian flu drives egg prices to record levels and increasingly poses a risk to humans, moves by the White House to cut spending and restrict communications have hobbled public health officials’ response, with the new administration yet to outline a clear strategy on how it plans to stem the spread of the virus.

State and local public health officials have gone weeks without regular updates on avian flu from the Centers for Disease Control and Prevention after President Donald Trump froze nearly all external communications from the agency, said a person familiar with the situation. It wasn’t until this week that some of those communications began to resume, the person said.

Widespread funding cuts across the government and new restrictions on funding for National Institutes of Health grants have also created uncertainty among infectious disease researchers and local health officials, who are unsure about what resources they will have to work with going forward. Meanwhile, cuts to the U.S. Agency for International Development have limited monitoring of the virus overseas.

“When you add that uncertainty, it plays into what health departments can do when their entire funding situation is at risk,” said Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials. “It makes it even harder to do more when you don’t think you’ll have the resources or they might get pulled out from under you.”

At the same time, key positions in the Trump administration central to responding to the threat of a pandemic have remained unfilled. And the secretaries running the Health and Human Services and Agriculture departments weren’t confirmed until this week, though bird flu was one of the first items on Agriculture Secretary Brooke Rollins' agenda after her confirmation.

The disruptions come at a potentially perilous time. The virus has been decimating poultry flocks, causing egg prices to more than double. It has been showing signs it can evolve to more easily thrive in a variety of species, including a new strain detected among dairy cattle this month. While there are no indications the virus can be transmitted among humans, at least 68 people in the U.S. have contracted avian flu and one person has died, according to the CDC. Researchers worry that the more the virus replicates, the more opportunities it will have to develop a mutation that would enable it to spread easily from human to human.

“This is getting more and more dangerous and urgent, and the scientific community is setting off alarm flares,” said Stephen Morrison, who directs the global health policy center at the Center for Strategic and International Studies. “But are they translating into the government moving at a faster pace or with a different resolve? No. Instead, we’re in a period of confused transition that’s been made worse by the disruptions in government function and the normal slowness of getting the new team in.”

The White House didn’t respond to a request for comment on its strategy for addressing avian flu and what additional steps it planned to take to address the spread of the virus.

Rollins, who was confirmed by the Senate Thursday, told reporters that she had a briefing in the Oval Office Thursday night and would be announcing more on the department’s plan to address egg prices “in the coming days.”

“We are looking at every possible scenario to ensure that we are doing everything we can in a safe, secure manner, but also to ensure that Americans have the food that they need,” Rollins said when asked about the price of eggs. “And as a mom of four teenagers, actually, I fully understand and feel the pain of the cost of these eggs.”

White House National Economic Council Director Kevin Hassett said in an interview on MSNBC Thursday that the Trump administration would soon have a strategy now that Rollins has been confirmed.

“It turns out, President Biden’s team didn’t have an avian flu strategy, and now we’re about to have one, as soon as Brooke Rollins is at the Department of Agriculture,” said Hassett.

In a statement on egg prices earlier this week, the White House said Rollins would take “bold, decisive action to address the crisis” by refocusing the agency tasked with stopping the spread of the virus among animals “on its core mission: protecting the health of the United States’ plants, animals, and natural resources while simultaneously lowering costs.”

So far, though, public health officials say the White House has created more confusion than clarity.

In West Virginia, Michael Kilkenny, head of the Huntington Health Department, said he hasn’t been getting regular updates from the CDC for the past several weeks.

“We just don’t know what’s happening right now. We don’t know if this is expanding into our area if we aren’t getting that communication from the CDC,” said Kilkenny. “In more rural areas, there are small health departments that, without the information they need coming from the CDC, they’re not going to be able to inform their small-flock farmers, poultry farmers or higher-risk agricultural workers that depend on the local health department for information or services.”

The prospect of potential federal funding cuts have also caused his and other health departments he works with to begin contingency planning and put hiring and new projects on hold.

“We are holding on hiring and we are holding on planning while we are waiting to see that there is clear evidence that things are going to be funded before we can spend our work time planning or even submitting for a project,” said Kilkenny. “That is how this disrupts us.”

Along with limiting CDC communications with local health officials, the World Health Organization has also been receiving limited information on the spread of avian flu in the U.S. since Trump signed an executive order to withdraw from the global health organization, WHO director-general Tedros Adhanom Ghebreyesus said during a Feb. 12 press conference.

The “near-total communication freeze” at public health agencies “is deeply unprecedented, and that alone scares me more than anything else,” said Jennifer Nuzzo, director of the pandemic center at the Brown University School of Public Health.

Nearly a month in, Trump has yet to name an official to head the White House Office of Pandemic Preparedness and Response Policy, which was created in 2022 by Congress to coordinate pandemic response across agencies. During the campaign, Trump said he would likely get rid of the office and criticized President Joe Biden’s efforts to prepare for another pandemic.

“He wants to spend a lot of money on something that you don’t know if it’s gonna be 100 years or 50 years or 25 years,” Trump said of Biden in a July interview with Time magazine. “And it’s just a way of giving out pork.”

“It doesn’t mean that we’re not watching out for it all the time,” Trump said. “But it’s very hard to predict what’s coming because there are a lot of variations of these pandemics.”

Trump’s key Cabinet officials who will be overseeing the federal response have given little insight into their strategy.

Rollins said during her Senate confirmation hearing last month that one of her top four priorities would be to put a team in place to stem the spread of avian flu, though she didn’t say what changes she would like to see the Agriculture Department make.

“There is a lot that I have to learn on this, and if confirmed, this will be, as I mentioned in my opening statement, one of the very top priorities,” Rollins said when asked about her response to avian flu. “We are hyperfocused on finding the team right now. I’m sure they’re already working. I have, obviously, respected the process and not gotten too involved. I know that the current team and the future team will be working hand in hand to do everything we can on animal disease.”

Health and Human Services Secretary Robert F. Kennedy Jr., who was confirmed by the Senate on Thursday, said during his confirmation hearing that he would focus more on tackling chronic disease, like heart disease and diabetes, and less on infectious diseases. When asked about devoting resources to avian flu during his confirmation hearing, Kennedy said he “intends to devote the appropriate resources to preventing pandemics. That’s essential for my job.”

Previously, Kennedy has said the currently available vaccines for avian flu that the U.S. has stockpiled may be dangerous and ineffective. Researchers are working on developing a new generation of avian flu vaccines based on the same mRNA technology used to develop the Covid vaccines, which Kennedy called the “the deadliest vaccine ever made,” though studies have shown it to be safe.

Kennedy has also been a proponent of drinking raw milk, which can put people at risk of foodborne illness, including avian flu. The CDC has warned that it might be possible to contract bird flu from drinking raw milk and urged Americans to drink only pasteurized milk.

Agriculture industry officials and infectious disease researchers have been calling on the federal government to significantly ramp up its response with greatly expanded testing, funding for research to better understand the virus and develop new treatments, and more assistance for dairy farmers to encourage them to test their cattle.

The United Egg Producers, an advocacy group for the egg industry, is urging the federal government and Congress to devote more resources to researching how the virus is spreading and evolving and to develop more effective and widespread vaccinations for animals. The industry group has also been calling for more rules and enforcement around the testing and movement of animals, and additional funding for local laboratories to provide quick and accurate test results.

“Our industry needs more from our state and federal government animal health partners — and we need it fast,” the United Egg Producers said in a statement.

The organization says its industry has lost more than 100 million egg-laying hens since 2022, including more than 29 million over the past four months. Once a flock of birds is infected with the highly pathogenic strain of the avian flu, the virus quickly spreads and is fatal in the vast majority of birds. When a flock becomes infected, farmers and veterinarians are supposed to notify the USDA, which will kill the entire flock and decontaminate the facilities. The federal government reimburses the farmers for the live birds that are culled in the process.

Public health researchers have said the Biden administration didn’t react quickly enough to stop the spread of the virus among dairy cattle after it was first detected in herds in March. It wasn’t until December that the Agriculture Department rolled out a national milk testing program, and three of the country’s top milk-producing states still aren’t a part of that federal surveillance effort.

The Trump administration will have to work with officials in states that still aren’t regularly testing their milk to try to get them on board, said Morrison. Texas’ state agriculture commissioner, Sid Miller, told NBC News that surveillance milk testing was unnecessary in Texas since there weren’t any active cases of bird flu in the state’s commercial cattle or poultry.

“From April until the end of the Biden administration, the response was slow and sluggish,” said Morrison. “We are still not testing animals and humans at the level that is needed, we still don’t have a coherent strategy and a system of accountability, and we still don’t have in place the kind of compensation mechanisms needed for those dairy farmers who suffer losses because of infections in their herds.”

Researchers worry the U.S. is running out of time to strengthen its response.

“If we don’t act now, we’re only giving the virus more opportunity to continue to adapt and potentially evolve into something more dangerous in a human population,” said Erin Sorrell, a senior scholar at the Johns Hopkins Center for Health Security. “Now is the time to act.”


Shannon Pettypiece

Sonya Stokes, an emergency room physician in the San Francisco Bay Area, braces herself for a daily deluge of patients sick with coughs, soreness, fevers, vomiting, and other flu-like symptoms.

She’s desperate for information, but the Centers for Disease Control and Prevention, a critical source of urgent analyses of the flu and other public health threats, has gone quiet in the weeks since President Donald Trump took office.

“Without more information, we are blind,” she said.

Flu has been brutal this season. The CDC estimates at least 24 million illnesses, 310,000 hospitalizations, and 13,000 deaths from the flu since the start of October. At the same time, the bird flu outbreak continues to infect cattle and farmworkers. But CDC analyses that would inform people about these situations are delayed, and the CDC has cut off communication with doctors, researchers, and the World Health Organization, say doctors and public health experts.

“CDC right now is not reporting influenza data through the WHO global platforms, FluNet [and] FluID, that they’ve been providing information [on] for many, many years,” Maria Van Kerkhove, interim director of epidemic and pandemic preparedness at the WHO, said at a Feb. 12 press briefing.

“We are communicating with them,” she added, “but we haven’t heard anything back.”

On his first day in office, President Donald Trump announced the U.S. would withdraw from the WHO.

A critical analysis of the seasonal flu selected for distribution through the CDC’s Health Alert Network has stalled, according to people close to the CDC. They asked not to be identified because of fears of retaliation. The network, abbreviated as HAN, is the CDC’s main method of sharing urgent public health information with health officials, doctors, and, sometimes, the public.

A chart from that analysis, reviewed by KFF Health News, suggests that flu may be at a record high. About 7.7% of patients who visited clinics and hospitals without being admitted had flu-like symptoms in early February, a ratio higher than in four other flu seasons depicted in the graph. That includes 2003-04, when an atypical strain of flu fueled a particularly treacherous season that killed at least 153 children.

Without a complete analysis, however, it’s unclear whether this tidal wave of sickness foreshadows a spike in hospitalizations and deaths that hospitals, pharmacies, and schools must prepare for. Specifically, other data could relay how many of the flu-like illnesses are caused by flu viruses — or which flu strain is infecting people. A deeper report might also reveal whether the flu is more severe or contagious than usual.

“I need to know if we are dealing with a more virulent strain or a coinfection with another virus that is making my patients sicker, and what to look for so that I know if my patients are in danger,” Stokes said. “Delays in data create dangerous situations on the front line.”

Although the CDC’s flu dashboard shows a surge of influenza, it doesn’t include all data needed to interpret the situation. Nor does it offer the tailored advice found in HAN alerts that tells health care workers how to protect patients and the public. In 2023, for example, a report urged clinics to test patients with respiratory symptoms rather than assume cases are the flu, since other viruses were causing similar issues that year.

“This is incredibly disturbing,” said Rachel Hardeman, a member of the Advisory Committee to the Director of the CDC. On Feb. 10, Hardeman and other committee members wrote to acting CDC Director Susan Monarez asking the agency to explain missing data, delayed studies, and potentially severe staff cuts. “The CDC is vital to our nation’s security,” the letter said.

Several studies have also been delayed or remain missing from the CDC’s preeminent scientific publication, the Morbidity and Mortality Weekly Report. Anne Schuchat, a former principal deputy director at the CDC, said she would be concerned if there was political oversight of scientific material: “Suppressing information is potentially confusing, possibly dangerous, and it can backfire.”

CDC spokesperson Melissa Dibble declined to comment on delayed or missing analyses. “It is not unexpected to see flu activity elevated and increasing at this time of the year,” she said.

A draft of one unpublished study, reviewed by KFF Health News, that has been withheld from the MMWR for three weeks describes how a milk hauler and a dairy worker in Michigan may have spread bird flu to their pet cats. The indoor cats became severely sick and died. Although the workers weren’t tested, the study says that one of them had irritated eyes before the cat fell ill — a common bird flu symptom. That person told researchers that the pet “would roll in their work clothes.”

After one cat became sick, the investigation reports, an adolescent in the household developed a cough. But the report says this young person tested negative for the flu, and positive for a cold-causing virus.

Corresponding CDC documents summarizing the cat study and another as-yet unpublished bird flu analysis said the reports were scheduled to be published Jan. 23. These were reviewed by KFF Health News. The briefing on cats advises dairy farmworkers to “remove clothing and footwear, and rinse off any animal biproduct residue before entering the household to protect others in the household, including potentially indoor-only cats.”

The second summary refers to “the most comprehensive” analysis of bird flu virus detected in wastewater in the United States.

Jennifer Nuzzo, director of the Pandemic Center at Brown University, said delays of bird flu reports are upsetting because they’re needed to inform the public about a worsening situation with many unknown elements. Citing “insufficient data” and “high uncertainty,” the United Kingdom raised its assessment of the risk posed by the U.S. outbreak on dairies.

“Missing and delayed data causes uncertainty,” Nuzzo said. “It also potentially makes us react in ways that are counterproductive.”

Another bird flu study slated for January publication showed up in the MMWR on Feb. 13, three weeks after it was expected. It revealed that three cattle veterinarians had been unknowingly infected last year, based on the discovery of antibodies against the bird flu virus in their blood. One of the veterinarians worked in Georgia and South Carolina, states that haven’t reported outbreaks on dairy farms.

The study provides further evidence that the United States is not adequately detecting cases in cows and people. Nuzzo said it also highlights how data can supply reassuring news. Only three of 150 cattle veterinarians had signs of prior infections, suggesting that the virus doesn’t easily spread from the animals into people. More than 40 dairy workers have been infected, but they generally have had more sustained contact with sick cattle and their virus-laden milk than veterinarians.

Instead, recently released reports have been about wildfires in California and Hawaii.

“Interesting but not urgent,” Nuzzo said, considering the acute fire emergencies have ended. The bird flu outbreak, she said, is an ongoing “urgent health threat for which we need up-to-the-minute information to know how to protect people.”

“The American public is at greater risk when we don’t have information on a timely basis,” Schuchat said.

This week, a federal judge ordered the CDC and other health agencies to “restore” datasets and websites that the organization Doctors for America had identified in a lawsuit as having been altered. Further, the judge ordered the agencies to “identify any other resources that DFA members rely on to provide medical care” and restore them by Feb. 14.

In their letter, CDC advisory committee members requested an investigation into missing data and delayed reports. Hardeman, an adviser who is a health policy expert at the University of Minnesota, said the group didn’t know why data and scientific findings were being withheld or removed. Still, she added, “I hold accountable the acting director of the CDC, the head of HHS, and the White House.”

Hardeman said the Trump administration has the power to disband the advisory committee. She said the group expects that to happen but proceeded with its demands regardless.

“We want to safeguard the rigor of the work at the CDC because we care deeply about public health,” she said. “We aren’t here to be silent.”

Amy Maxmen: amaxmen@kff.org

CNN
—
Blood testing of large-animal veterinarians suggests that H5N1 bird flu has spread more widely than US surveillance of the virus is capturing, according to a new study by federal and state disease detectives.

The study comes as Ohio announced its first human case of H5N1 in a poultry worker who was hospitalized with respiratory symptoms but has since recovered.

The new study of vets found that three of the 150 who signed up to be tested – or 2% – had antibodies against bird flu in their blood. Antibodies indicate that the vets were infected with bird flu, although they didn’t have symptoms.

It is one of three studies on bird flu that were delayed after the Trump administration issued a pause on outside communications from federal health agencies last month.

The study on blood testing of vets who treat cows was released Thursday in the Morbidity and Mortality Weekly Report, which is published by the US Centers for Disease Control and Prevention.

The other studies, which still have not been released, reportedly detail transmission between cats infected with bird flu and people in the same household, and discuss H5N1 detections in wastewater.

Blood tests in veterinarians
For the research, called a seroprevalence study because it looks for evidence of infections in the blood to try to determine a population’s exposure to disease, researchers from the CDC and the Ohio Department of Health went to the annual meeting of the American Association of Bovine Practitioners, which was held in September in Columbus.

Before the meeting, the CDC emailed members to ask whether they’d like to participate. It enrolled 150 veterinarians from 46 states and Canada who had their blood drawn at the conference. Just over half were from states known to have positive dairy herds, and 1 in 4 said they’d worked with infected cattle.

Three vets’ blood tests came back positive for antibodies to the H5N1 virus, even though none of them had experienced any memorable symptoms or worked with cows that had tested positive for H5N1. One vet who had antibodies had worked with infected poultry, however, according to the study.

One veterinarian who tested positive said they’d treated cattle in Georgia and South Carolina, two states with no reported infections in cows.

The report’s authors write that their findings suggest there may be H5N1 infections in cows in states that haven’t reported any, and they highlight the need for faster and more comprehensive testing of animals and milk to identify infected herds.

Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University, said the study had good news and bad news.

The bad news, she said, is that bird flu is spreading where we don’t have eyes on it.

“I think the bottom line here is that there are vets who may have been infected in states that hadn’t reported outbreaks, which is bad,” Nuzzo said. “It speaks to the need to improve our surveillance so that we can better detect when outbreaks are occurring on farm so we can protect people.”

The good news is that the researchers didn’t see evidence of a large number of under-the-radar infections.

“We’re not missing some huge submerged iceberg of mild infections that would possibly make us think that this virus could be much milder than what it has historically been,” Nuzzo said.

Other experts said the study spoke to some of the challenges veterinarians face in protecting themselves from the virus.

“This report tells us is that this virus can infect and present without symptoms in animals and that enough virus is shed either directly from animal to veterinarian or via touching surfaces to infect the vet,” said Dr. Erin Sorrell, a senior scholar at the Johns Hopkins Center for Health Security. Nuzzo and Sorrell did not work on the new study.

Bird flu infections in humans remain rare
There is no evidence that H5N1 is spreading from person to person. The CDC says the risk to the public remains low, although people who work on farms and with infected animals, or who have backyard poultry flocks, are at higher risk of an H5N1 infection.

Since March 2024, there have been 68 confirmed H5N1 infections in people in the US. All but three have had known exposures to animals.

Two of those cases have been severe, including an older person in Louisiana who died last year.

The most recent serious infection was a farm worker in Ohio who had contact with infected birds. Ohio announced its first bird flu case in a human on Wednesday.

That person was hospitalized with respiratory symptoms but has since recovered, according to a health official familiar with the details of the case who was not authorized to speak to the media.

The subtype of the virus has not been confirmed, but it is probably the newer strain, D1.1, the official said.

A new study published by the U.S. Centers for Disease Control and Prevention shows that the H5N1 bird flu virus is probably circulating undetected in livestock in many parts of the country and may be infecting unaware veterinarians.

In the health agency’s Morbidity and Mortality Weekly Report, a group of researchers from the CDC, the Ohio Department of Health and the American Assn. of Bovine Practitioners, reported the results of an analysis they conducted on 150 bovine, or cow, veterinarians from 46 states and Canada.

They found that three of them had antibodies for the H5N1 bird flu virus in their blood. However, none of the infected vets recalled having any symptoms — including conjunctivitis, or pink eye, the most commonly reported symptom in human cases.

The three vets also reported to investigators that they had not worked with cattle or poultry known to be infected with the virus. In one case, a vet reported having practiced only in Georgia (on dairy cows) and South Carolina (on poultry) — two states that have not reported H5N1 infections in dairy cows.

Seema Lakdawala, a microbiologist at Emory University in Atlanta — who was not involved in the research — said she was surprised that only 2% of the veterinarians surveyed tested positive for the antibodies, considering another CDC study showed that 17% of dairy workers sampled had been infected. But she said she was even more surprised that none of them had known they were infected or that they had worked with infected animals.

“These surprising results indicate that serum surveillance studies are important to inform risk of infections that are going undiagnosed,” she said. “Veterinarians are on the front line of the outbreak, and increased biosafety practices like respiratory and eye protection should reduce their exposure risk.”

Jennifer Nuzzo, director of the Pandemic Center at Brown University, described the study as a “good and bad news story.”

“On one hand, we see concerning evidence that there may be more H5N1 outbreaks on farms than are being reported,” she said. “On the other hand, I’m reassured that there isn’t evidence that infections among vets have been widespread. This means there’s more work that can and should be done to prevent the virus from spreading to more farms and sickening workers.”

The analysis was conducted in September 2024. At that time, there had been only four human cases reported, and the infection was believed to be restricted to dairy cattle in 14 states. Since then, 68 people have been infected — 40 working with infected dairy cows — and the virus is reported have infected herds in 16 states.

John Korslund, a retired U.S. Department of Agriculture scientist, said in an email that finding H5N1 antibodies in the blood of veterinarians was an interesting “but very imprecise way to measure state cattle incidence.” But it underscored “that humans ARE susceptible to subclinical infections and possible reassortment risks, which we already knew, I guess.”

Reassortment occurs when a person or animal is infected with more than one influenza virus, allowing the two to mingle and exchange “hardware,” potentially creating a new, more virulent strain.

More important, he said, the D1.1 version of the strain — which has been detected in Nevada dairy cattle and one person living in the state — is “changing the landscape. ... [P]eople may be more more susceptible (or not) with a greater potential for severeness (or not).”

“I’m confident that we’ll find it in other states. Its behavior and transmissibility within and between cattle herds is still pretty much a black box,” he said.

Copyright Los Angeles Times Communications LLC 2025

In October, Stanford University professor Jay Bhattacharya hosted a conference on the lessons of COVID-19 in order “to do better in the next pandemic.” He invited scholars, journalists, and policy wonks who, like him, have criticized the U.S. management of the crisis as overly draconian.

Bhattacharya also invited public health authorities who had considered his alternative approach reckless. None of them showed up.

Now, the “contrarians” are seizing the reins: President Donald Trump has nominated Bhattacharya to lead the National Institutes of Health and Johns Hopkins University surgeon Marty Makary to run the Food and Drug Administration. Yet the polarized disagreements about what worked and what didn’t in the fight against the biggest public health disaster in modern times have yet to be aired in a nonpartisan setting — and it seems unlikely they ever will be.

“The whole COVID discussion turned into culture war dialogue, with one side saying, ‘I believe in the economy and liberty,’ and the other saying, ‘I believe in science and saving people’s lives,’” said Philip Zelikow, a scholar and former diplomat based at Stanford’s Hoover Institution.

Frances Lee, a Princeton University political scientist, has a book coming out that calls for a national inquiry to determine the lockdown and mandate approaches that were most effective.

“This is an open question that needs to be confronted,” she said. “Why not look back?”

For now, even with the threat of an H5N1 bird flu pandemic on the horizon, and some other plague waiting in the wings of a bat or goose in a far-flung corner of the world, U.S. public health officials face ebbing public trust as well as a disruptive new health administration led by skeptics of established medicine.

Zelikow led the 34-member COVID Crisis Group, funded by four private foundations in 2021, whose work was intended to inform an independent inquiry along the lines of the 9/11 Commission, which Zelikow headed.

The COVID group published a book detailing its findings, after Congress and the Biden administration abandoned initiatives to create a commission.

That was a shame, said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health, because “while there are some real ideological battles over COVID, there’s also lots of stuff that potentially could be fixed related to government efficiency and policy.”

...

Channel 9 is the Educational Access Channel. All public, parochial or other non-profit schools recognized by the State Department of Education are eligible for programming on Channel 9. Also eligible; U-Mass Dartmouth and Bristol Community College. Types of programs that are aired on Channel 9 include school graduations, concerts & plays, School Committee meetings, reading programs, educational forums and school athletic events. Education Access Programming – Channel 9 918 S. Rodney French Blvd. – New Bedford, MA 02744 Tel: 508-979-1775 – Fax: 508-979-1764

Dr Wilmot James is a Professor in the School of Public Health, Brown University. He served as a Member of Parliament in South Africa between 2009 and 2017, and Federal Chairperson of the Democratic Alliance (DA) between 2010 and 2016.

For the likes of Trump and Musk, human misfortune appears as if it is mere collateral damage in the longer-term effort to engineer their version of sustainable Western civilisation, on Earth as it will be on Mars.

Nelson Mandela spent 27 years in prison for his beliefs. He emerged with an enduring desire to establish a democratic and free society for all and not just some. He believed that South Africa could only succeed if the assets and talents of everyone including all minority populations were included in a forward-looking historical project for South Africa he called nation-building.

It is with the greatest regret that US President Donald Trump and his helper Elon Musk today seek to undo and shatter the peacemaking efforts of one of the greatest leaders of the 20th century.

Today the world’s most powerful man has struck a bargain with the world’s wealthiest man to bully South Africa into change by energising a small group of disgruntled extremists, destabilising the country’s politics and punishing its people.

South Africa’s Expropriation Act 13 of 2024 is merely a hook by which they launched their efforts, by twisting a law that is not race-based into one that supposedly is, thereby igniting the energies of a South African domestic constituency to join their global cause. In this effort, they join Steve Bannon, widely regarded as the Lenin of the Right.

...

CNN reports a Nevada dairy worker may have been infected by deadly D1.1 version of H5N1 bird flu
Worker shows only mild symptoms
Genetic analyses of this version show changes that could make it pass more easily between people
A dairy worker in Nevada may have tested positive for a strain of H5N1 bird flu known to have killed one person and severely sickened another.

CNN reported Saturday night that a worker tested positive for the D1.1 version of the H5N1 bird flu virus. Confirmation testing by the Centers for Disease Control and Prevention is underway.

The report has not been confirmed by the CDC or Nevada’s Department of Health and Human Services.

According to CNN, the person’s symptoms include conjunctivitis, or pink eye — a common symptom that has been seen in people who have been exposed to the virus in North America since March 2024, when the virus was first reported in Texas dairy herds.

Since that time, 67 people have been infected with H5N1 bird flu. In 63 of those cases, workers picked up the virus while working with infected animals; 40 got it working with dairy cattle, 23 with infected poultry. In three cases, the source of exposure was not determined. And in one case, a person got it from handling sick and or dead birds in a backyard flock. That person died.

Last week, federal health officials announced that at least four dairy herds in Nevada had been infected by a strain of the H5N1 bird flu that is circulating in wild birds and that led to the death of one person in Louisiana and several sickened a teenager in Canada. That strain is called D1.1, and it is slightly different than the one that had been circulating widely in the nation’s dairy herds, which is called B3.13.

The news comes on the heels of a U.S. Department of Agriculture report that examined the D1.1 strain found in the Nevada dairy cows and found changes in the genetic code thought to help the virus copy itself more easily in mammals, including humans.

Researchers have not been able to determine how the wild bird version of the virus spilled into Nevada herds, although there were reports of massive bird die-offs in the area during that period.

Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health, said if confirmed, it’s a relief this latest dairy worker is reported to have only shown mild symptoms, but she underscored how little we actually know about who gets sick and why when it comes to H5N1 bird flu.

She said there are several hypotheses floating around about why most dairy workers have, thus far, only shown mild symptoms after infection when compared to the severe cases reported in two people who had been exposed to D1.1. (Several poultry workers in Washington were also exposed to D1.1 while depopulating an infected poultry operation. While many had respiratory symptoms, they were considered mild cases by public health officials.)

One of those theories is that the H5N1 B3.13 version is less dangerous than D1.1, she said.

“I’ve not been convinced of that,” she said.

Now seeing someone having milder infection with D 1.1, “I think, just raises more questions about why some people have severe illness and why some people don’t,” she said. “I would argue that at this point, we have no idea ... and we shouldn’t assume that just because someone was exposed to one variant or another means they’re going to have mild or severe illness. ... We shouldn’t assume that H5N1 is in any way destined to be a mild virus. And for that reason, we need to treat each infection with caution and work to prevent future infections.”

Asked if she was surprised that roughly one year into the outbreak of H5N1 bird flu in dairy cattle people are still getting sick and infected, she said “no.”

Little has been done to increase the protection of dairy workers against this virus, she said, and health officials have not “done much to try to stay ahead of how this virus is transmitting and where.”

...

Here & Now's Scott Tong speaks with epidemiologist Jennifer Nuzzo about the rising cases and different strains of the bird flu popping up all over the country.

On this edition of Your Call, we discuss Trump administration's attack on public health.

We also look the consequences for public health and vaccines should RFK Jr. – who is now headed to the Senate for a confirmation vote and bird flu’s unprecedented spread in livestock and other mammals – including human cases – amid concerns it could become the next pandemic to hit the U.S. if these outbreaks are not properly addressed.

Guests:

Dr. Jenner Nuzzo, Professor of Epidemiology and Director of the Pandemic Center at Brown University School of Public Health

Dr. Paul Offit, Professor at the Perelman School of Medicine at the University of Pennsylvania and the Director of the Vaccine Education Center at Children’s Hospital of Philadelphia

The data, which appeared fleetingly online on Wednesday, confirmed transmission in two households. Scientists called on the agency to release the full report.

Cats that became infected with bird flu might have spread the virus to humans in the same household and vice versa, according to data that briefly appeared online in a report from the Centers for Disease Control and Prevention but then abruptly vanished. The data appear to have been mistakenly posted but includes crucial information about the risks of bird flu to people and pets.

In one household, an infected cat might have spread the virus to another cat and to a human adolescent, according to a copy of the data table obtained by The New York Times. The cat died four days after symptoms began. In a second household, an infected dairy farmworker appears to have been the first to show symptoms, and a cat then became ill two days later and died on the third day.

The table was the lone mention of bird flu in a scientific report published on Wednesday that was otherwise devoted to air quality and the Los Angeles County wildfires. The table was not present in an embargoed copy of the paper shared with news media on Tuesday, and is not included in the versions currently available online. The table appeared briefly at around 1 p.m., when the paper was first posted, but it is unclear how or why the error might have occurred.

The virus, called H5N1, is primarily adapted to birds, but it has been circulating in dairy cattle since early last year. H5N1 has also infected at least 67 Americans but does not yet have the ability to spread readily among people. Only one American, in Louisiana, has died of an H5N1 infection so far.

The report was part of the C.D.C.’s prestigious Morbidity and Mortality Weekly Report, which, until two weeks ago, had regularly published every week since the first installment decades ago. But a communications ban on the agency had held the reports back, until the wildfire report was published on Wednesday.

Experts said that the finding that cats might have passed the virus to people was not entirely unexpected. But they were alarmed that the finding had not yet been released to the public.

“If there is new evidence about H5N1 that is been held up for political purposes, that is just completely at odds with what government’s responsibility is, which is to protect the American people,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.

It was important that the C.D.C. immediately publish the full data and the context in which they were collected for other scientists to review, she said.

Scientists have long known that cats are highly susceptible to the virus. At least 85 domestic cats have been infected since late 2022, according to the U.S. Department of Agriculture. But there had not previously been any documented cases of cats passing the virus to people.

Although cats may be infected when they prey on infected wild birds, cases among domestic cats in the United States began rising last year as the virus spread through dairy farms. On many farms, dead cats were the first signal that cows had been infected. Several recent cases in pet cats have also been linked to contaminated raw pet food or raw milk.

H5N1 is often fatal in cats, which may develop severe neurological symptoms.

Historically, H5N1 has primarily affected birds. But over the last several years, new versions of the virus have proved capable of infecting a wide range of mammals, including wild and domestic cats, seals and dairy cows. Infections in mammals give the virus more opportunities to evolve in ways that could allow it to infect humans more easily.

Copyright 2025 The New York Times Company

If it seems like almost everyone you know is getting sick with influenza or some other virus right now, it’s not your imagination. The Northern Hemisphere’s respiratory illness season, which typically runs from October to May, is in full swing. Flu hospitalizations appear to have declined from an initial peak in January, but they remain high, and cases may be rebounding. Levels of the virus that causes COVID detected in wastewater are also high and may be rebounding. And respiratory syncytial virus (RSV) is still putting people in the hospital, albeit at lower levels than flu or COVID. Yet despite all the sniffles, it’s shaping up to be a fairly typical year for respiratory viruses.

Flu
So far, this year’s flu season looks pretty similar to that of previous years—with the exception of 2020–2021, when flu all but disappeared because of COVID-related masking and social distancing measures. This season’s weekly hospitalization rate reached a peak around January 4 and then appeared to decline, though the Centers for Disease Control and Prevention indicated there may be possible delays in reporting. The latest positive test rate data (some of which were released several days late under the new presidential administration) show a slight rebound in infections, so we may not be out of the woods. There have been some reports that this year’s flu vaccine might be less effective than in previous years, which could explain the apparent high levels of sickness that are currently around. But this season doesn’t seem to be particularly more severe than others.

This year’s flu season started a bit late, says Jennifer Nuzzo, a professor of epidemiology and director of the Pandemic Center at the Brown University School of Public Health. But we’re still in the thick of it, she says. “I don’t know how it’s going to play out,” Nuzzo adds.

To prevent becoming seriously ill with flu, health officials still recommend getting the flu vaccine if you haven’t already, especially if you are age 65 or older or have underlying health conditions. Masking, avoiding crowds and being in well-ventilated spaces are always helpful at reducing the chance of getting infected. And if you should test positive for flu, antiviral drugs such as Tamiflu are available by prescription.

The fact that this year’s season started slightly later than last year’s is a relief, Nuzzo says, in light of the ongoing H5N1 avian influenza outbreaks in cows and poultry that have caused 67 human infections and one death in the U.S. Nuzzo is worried about people getting infected with both H5N1 and seasonal flu—a situation that could increase the risk of bird flu adapting to humans and becoming a pandemic. “I’m a bit relieved because I was fretting about the co-occurrence of H5N1 and seasonal influenza,” she says. “I’m worried about humans getting infected with both viruses.”

...

Bird flu is spreading fast. The virus is infecting chickens, ducks, turkeys and cows across the U.S. and Ohio is leading the nation in cases. Nearly 9 million birds have been affected, mainly in Western counties like Darke and Mercer.

Ohio is the second-largest producer of eggs in the country, so officials believe this outbreak will have devastating impacts on the poultry industry nationwide.

Tuesday on the "Sound of Ideas," we'll talk about H5N1 virus that is continuing to adapt and has started infecting humans.

As of January, 67 people were infected by a strain of the virus called H5N1, according to the Centers for Disease Control. The first death occurred on Jan. 6.

While no human cases have been reported in the state, officials are working to contain the outbreak by euthanizing infected flocks and composting the carcasses.

For now, humans are at low risk for contracting the virus, but experts say this may change as cases continue to rise.

Later in the hour, we'll talk about an exciting opportunity for commercial astronauts in Northeast Ohio. They'll have the chance to study and experience extreme levels of gravity thanks to a new agreement between NASA Glenn's Research Center and Blue Abyss, a U.K. based commercial aeronautics company.

Blue Abyss plans to study human spaceflight, training and simulations of extreme environments- preparing for challenges in low-Earth orbit, on the moon and on Mars.

The company purchased 12 acres of land from the city of Brook Park to build its first American campus, which is still in the early stages. The project is estimated to cost upwards of $253 million when construction is completed.

Guests:
-Dr. Amy Edwards, M.D., Pediatric Infectious Diseases, University Hospitals
-Dr. Jennifer Nuzzo, Dr. P.H., Director of the Pandemic Center, Professor of Epidemiology, Brown University
-Brian Baldridge, Director, Ohio Department of Agriculture
-Josh Freeh, Manager, Human Exploration and Space Operations Project Office, NASA Glenn Research Center
-Edward Orcutt, Mayor, City of Brook Park
-John Vickers, CEO, Blue Abyss

When Rwanda announced an outbreak of the highly infectious Marburg disease in September, partners from around the world, including the U.S. Agency for International Development (USAID), provided emergency funding to help curb it. Marburg kills 88% of the people who catch it, but this funding, in conjunction with efforts from the Rwandan ministry of health, rapidly contained and treated 51 of 66 cases in what was thought to have largely been a public health victory.

On the day of President Donald Trump’s inauguration, another Marburg outbreak was announced in Tanzania, where the virus has thus far killed at least eight people. Meanwhile, Ebola (a virus similar to Marburg, also with a high fatality rate) was recently detected in Uganda; public health officials are struggling to contain mpox in Africa; and H5N1, the virus commonly referred to as bird flu continues to infect an unprecedented number of people and species around the globe.

Many are concerned that the Trump Administration’s actions in the first two weeks of operation, including signaling that he would withdraw from the World Health Organization (WHO) and issuing a freeze on public health communications, are hampering the nation’s potential to respond to these various infectious disease threats at a time when protective measures need to be ramped up most.

“It’s just a sucker punch in your gut,” said Dr. Syra Madad, an infectious disease epidemiologist at NYC Health and Hospitals. “These threats are not going away — in fact, it’s the opposite. They are increasing.”

Since the U.S. helped found the WHO in 1948, its partnership with the global health agency and its member countries has helped curb countless outbreaks, including ending smallpox and bringing polio to the brink of eradication. The U.S. is the largest donor to the agency in the world.

The partnership with the WHO facilitates U.S. participation in various global surveillance systems for infectious disease threats that could touch down in the country. It allows the U.S. and participating countries to share vaccine stockpiles, pool international data about infectious disease risks, and even send public health workers to countries with outbreaks to help with contract tracing and other surveillance efforts.

Withdrawing from the WHO would mean forgoing these existing networks and destroy trust that has been built up over decades of international collaborations.

“They’re not looking at the damage this is going to cause the United States’ credibility," Madad told Salon in a phone interview. "When the next administration comes around, it’s going to undermine the United States’ leadership in public health."

In the Democratic Republic of the Congo, where another suspected Ebola outbreak was recently reported, unrelated violence erupted in the capital city of Kinshasa, motivating the U.S. to close its embassy there and remove staff, said Dr. Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University School of Public Health.

“You have a possible Ebola outbreak happening in the country at the same time you are trying to repatriate Americans,” Nuzzo told Salon in a phone interview. “To not be able to talk to the partners that may know what is going on to help assess risks and what it means for people returning … you start to see what we lose by not being able to engage.”

...

By Elizabeth Hlavinka
Elizabeth Hlavinka is a staff writer at Salon covering health and drugs. She specializes in exploring taboo topics and complex questions that help humans understand their place in the world.

MORE FROM Elizabeth Hlavinka

Days after President Donald Trump took office, the Department of Health and Human Services imposed an indefinite "pause" on communications, silencing the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR) for the first time in it 60 years of existence. The journal, which once documented the first AIDS cases, has missed two editions with no return date.

MMWR "is really important for states to read to have a more in-depth understanding of what might be going on and what to do about it," Jennifer Nuzzo, director of the Pandemic Center at Brown University, told AFP, calling the pause a "radical departure" from norms.

The overall communications freeze has also prevented federal officials from updating the public or even state and local officials on bird flu, which has so far killed one person and sickened dozens, said Nuzzo.

Meanwhile, CDC scientists have been instructed to retract or revise all papers submitted to external journals to remove language deemed offensive -- including the word "gender," Jeremy Faust, a physician and Harvard instructor who runs the Inside Medicine Substack, was the first to report.

Nuzzo stressed that gender identity, not just biological sex, is crucial in targeting interventions, as seen with mpox, which disproportionately affects men who have sex with men and transgender women.

- Critical resources for doctors scrubbed -

Doctors were blindsided by the sudden removal of a CDC app that assessed contraceptive suitability based on medical history -- for example, progestin-only pills are advised for patients with liver disease.

Also deleted: CDC pages containing clinical guidance for PrEP (a critical HIV-prevention tool), resources on intimate partner violence, guidelines on LGBTQ behavioral health, and more.

"I'm really not sure what is so radically leftist about treating gonorrhea," Natalie DiCenzo, an obstetrician-gynecologist and member of Physicians for Reproductive Health, told AFP, on the removal of STI guidelines.

Some pages have since been restored but now carry an ominous disclaimer: "CDC's website is being modified to comply with President Trump's Executive Orders."

Jessica Valenti, a feminist author and founder of the Abortion, Every Day Substack, has been archiving deleted materials on CDCguidelines.com to preserve their original, inclusive versions.

"The hope is to have it be a resource for the people who need it," she told AFP, adding that even if documents are later restored, words like "trans" may be scrubbed from them.

"Deleting data of groups of people who are clearly not prioritized by this administration is essentially erasing them," Angela Rasmussen, a prominent US virologist told AFP. "It's going to cause people to suffer, and die."

- Infectious outbreaks unreported -

As medical associations sound the alarm over the lack of federal health communication, outbreaks are slipping under the radar.

In Kansas City, Kansas, what is reportedly the largest tuberculosis outbreak in modern US history is unfolding -- with 67 active cases since 2024. Yet no national health authority has reported on it.

"The National Medical Association (NMA) is calling for a swift resolution to the federal health communications freeze, which has the potential to exacerbate this outbreak and other public health threats," wrote the group, which represents African American physicians.

Caitlin Rivers, senior scholar at the Center for Health Security at Johns Hopkins University, writes a weekly newsletter updating readers on disease outbreaks in her free time, relying on CDC data for influenza tracking.

"The last two weekends, I have had to compile data by hand because key data sources have been unavailable," she told AFP.

© 2025 AFP

Several US Centers for Disease Control and Prevention websites and datasets related to HIV, LGBTQ people, youth health behaviors and more have been removed after the agency was directed to comply with executive orders from President Donald Trump. Epidemiologist Dr. Jennifer Nuzzo explains the consequences.

Just as Massachusetts is experiencing a large outbreak of avian flu, the flow of scientific information from the federal government that state officials need to combat the outbreak has become unreliable.

It’s a lot more than just birds that could be affected if updates do not resume on a consistent basis: Aggressively responding to the disease when it’s mostly affecting birds and livestock is the best way to ensure it doesn’t spread further to humans.

In a call with reporters Wednesday, state ornithologist Andrew Vitz said between 500 and 1,000 suspected cases of avian flu have been reported in wild birds in Massachusetts (there may be multiple reports about each bird). The actual number of infected wild birds is likely much higher.

Some domestic birds have also been affected. One 30-bird flock of domestic chickens in Plymouth had to be euthanized because of infections.

Highly Pathogenic Avian Influenza, or H5N1, can be fatal to birds. Waterfowl and aquatic birds are most at risk, along with raptors that eat bird carcasses. Avian flu has also spread to dairy cows, with around 950 infected herds reported nationwide, although none so far in Massachusetts. Most worryingly, there have been 67 reported human cases and one death, according to the US Centers for Disease Control and Prevention, almost all of them among people exposed to infected birds or cattle. The biggest fear about avian flu is that it will mutate to a form that’s more dangerous to people.

Soon after he took office, President Trump imposed a freeze on federal health agencies’ meetings and public communications. Despite that, the US Department of Agriculture is updating its public website about the number of bird flocks affected by flu and the CDC is updating its tally of infected dairy cow herds.

But researchers say there has been less communication over the last two weeks than before from the federal government.

Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health, said the CDC canceled all of the regular informational calls and briefings it typically holds with state and local public health partners.

Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, said in an email that in addition to the lack of updates to stakeholders, groups at the CDC and National Institutes of Health that do work related to the avian flu were put on hold. “The confusion over messaging and who can say what or anything is complicating matters at a bad time,” Poulsen said.

Kaiser Health News reported that the Trump administration stopped the publication of new studies related to whether veterinarians who treat cattle have been infected by bird flu and whether infected people have spread the virus to pet cats. The studies had been scheduled to be released in the CDC’s Morbidity and Mortality Weekly Report, a weekly publication that, as of Thursday, has not published since Jan. 16.

Massachusetts state epidemiologist Catherine Brown said the communications freeze is a “disappointment,” but if the pause is only two weeks, it is unlikely to result in a significant impact on the state’s ability to track or respond to avian flu. The Trump administration has called the pause short-term, but it is unclear when communications might fully resume. Massachusetts is continuing to communicate with officials in other Northeast states and national professional organizations of epidemiologists and public health labs.

For now, state recommendations are to follow basic precautions: Stay away from sick or dead birds; report sick poultry to state wildlife officials; keep cats indoors and pets away from wildlife; eliminate standing water; isolate new birds before adding them to a flock; and take biosecurity measures around domestic birds, like disinfecting equipment.

Going forward, it will be important for scientists and health officials to track the disease’s spread and continue learning about how it is transmitted, who is at risk, and what preventative measures and treatments are recommended. Federal government agencies like the CDC, USDA, and NIH are well-poised to do this research and communicate their findings nationwide. Trump shouldn’t just let them do that; he should insist that they do.

Vague federal directives have led to frantic action, and perhaps overreaction, before a Friday deadline.

Federal and state health officials and staff members scrambled on Friday to comply with a 5 p.m. deadline by the Trump administration to terminate any programs that promote “gender ideology,” and to withdraw documents and any other media that may do so.

Federal workers had already been ordered to halt diversity, equity and inclusion initiatives, to scrub public references to those efforts and to place employees involved in them on administrative leave.

At federal health agencies, veterans hospitals, and local and state health departments, compliance took a variety of forms. At the Centers for Disease Control and Prevention, employees hurried to remove terms like “transgender,” “immigrant,” “L.G.B.T.” and “pregnant people” from the website.

Employees at some VA Hospitals were told that L.G.B.T.Q. flags and other displays were no longer acceptable, according to an administrative email reviewed by The New York Times.

Bathrooms at health agencies were to be set aside for use by a single “biological sex,” according to federal directives, and the word “gender” was to be removed from agency forms.

The instructions are a 180-degree pivot for health scientists and clinicians, who have worked for years to integrate diversity and equity into research and clinical services, including those for gay, lesbian and transgender individuals.

The directives “risk dismantling programs that have been built up over decades to serve the needs of Americans,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.

“What I’m worried about here is that in this attempt to make headlines, we’re issuing very bold and broad statements,” she said of the administration.

The upheaval followed two executive orders that President Trump issued on Jan. 20. The one entitled “Ending Radical and Wasteful Government DEI Programs and Preferencing” terminated the federal government’s D.E.I. efforts.

The other, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” shut down governmental efforts to be more inclusive of a variety of gender expressions, including in scientific research.

In both instances, the federal Office of Personnel Management followed up with memos explaining how to carry out the changes and issuing deadlines. The memos affected a broad swath of programs at all levels of government, but details were sparse.

Some employees at the C.D.C. were befuddled by an order, for example, to delete mentions of gender from research databases, some dating back decades, as other government rules prohibit manipulation of scientific data.

Agency web pages that have been deleted as part of President Trump’s “Defending Women” initiative include ones about ending gender-based violence and supporting L.G.B.T.Q. youths, and another about racism in health.

C.D.C.’s AtlasPlus, which holds 20 years of surveillance data for H.I.V., tuberculosis, hepatitis B and other diseases, is missing.

Also removed were the pages of the C.D.C.’s Youth Risk Behavior Surveillance System, which surveys youngsters about dangerous activities like drinking and drug use, smoking and risky sexual behaviors that can lead to unintended pregnancies and sexually transmitted diseases.

The survey reported recently on the high rates of depression among teenage girls and lesbian, gay and bisexual youth.

Some directives from agency administrators, including one emailed to Veterans Affairs hospitals and reviewed by The Times, ordered the termination of “accessibility” programs, as well as other diversity and inclusion initiatives.

The hospitals treat military veterans, many of whom are disabled.

The C.D.C. itself told funding recipients on Wednesday that “any vestige, remnant, or renamed piece” of diversity programs funded by the federal government “are immediately, completely, and permanently terminated,” according to an unsigned memo obtained by The Times.

Diversity and inclusion programs at federal agencies have also been disbanded, and scientific work groups have been ordered to halt their activities, according to an email reviewed by The Times.

Public health experts warned that the D.E.I. prohibitions affect not only diversity in staffing, but health equity programs aimed at disadvantaged populations.

For example, some programs help seniors with low incomes gain access to vaccines and provide assistance to communities of color who are at increased risk of conditions like diabetes.

Including gender as a research factor in studies helps identify groups at risk of sexually transmitted infections like syphilis, which has reached its highest levels in 50 years.

“Health equity is basically all of public health,” Dr. Nuzzo said.

“This work and these data and these studies are really important for us to answer the essential question of public health, which is, Who is being affected and how do we best target our limited resources?” she said.

None of this would seem to align with the goals of Robert F. Kennedy Jr., President Trump’s nominee for health and human services secretary, who has made chronic diseases a main talking point. Most chronic conditions disproportionately affect people who are socially disadvantaged, including rural Americans and people of color.

Some state health administrators have interpreted the D.E.I. directives as applying only to hiring and promotion. Health programs that do outreach to disadvantaged populations, including ethnic and racial minority groups, will not be affected, they have told staff members.

But one employee at a state H.I.V. prevention program said the new edicts about gender may hamper the program.

“We are still not sure how this will affect our work if we are not allowed to talk about individuals who are transgender, as that is a lot of the population we work with in H.I.V.,” said the employee, who asked not to be identified for fear of retribution.

Some V.A. hospitals have warned employees that prohibited D.E.I. activities include “displaying of pride symbols, e.g. flags, lanyards, signature blocks, etc.,” prompting employees at New York hospitals to remove wall hangings that indicated they were welcoming to lesbian, gay and transgender patients.

Some asked their supervisors whether they also needed to remove books from their offices. The ambiguity of the federal directives, coupled with employees’ heightened anxiety, “may lead them to take a sledgehammer when they really need a scalpel,” Dr. Nuzzo said.

At one V.A. facility, administrators deleted all computer folders and files with the term “D.E.I.” in the name. “We gave them access to files and they disappeared from our folders,” said one employee speaking on condition of anonymity.

“I think no one knows what to say,” the employee said. “Everyone’s walking on eggshells.”

Agencies were instructed to turn off software features that prompted users to enter their pronouns in their signatures. The C.D.C. also deleted personal pronouns from its internal directory.

The administration has also threatened employees who don’t inform on colleagues who defy the orders or who try to “disguise these programs by using coded or imprecise language.”

Already, contractors working on health equity issues are being let go. At least one worker on a longtime contract was fired because of his role supporting such a project a year ago.

Some C.D.C. officials began preemptively censoring material that discussed health equity even before Mr. Trump took office.

Fearing that their programs would be shut down, they began deleting content from websites and holding back research findings, including those from a project that cost about $400,000.

But for other projects, merely snipping out mentions of equity or gender is impossible, because they are aimed specifically at reducing health disparities in chronic conditions.

“I don’t think that there’s anything that our division works on that wouldn’t have to stop,” said one C.D.C. employee who wished to remain anonymous for fear of retaliation.

Anticipating that the Trump administration may take aim at certain issues, some scientific groups have archived data related to H.I.V. and other sexually transmitted infections, as well as births and deaths, education, environment and housing.

On Friday, hundreds of scientists gathered for a “datathon,” in an attempt to preserve websites related to health equity.

“There’s been a history in this country recently of trying to make data disappear, as if that makes problems disappear,” said Nancy Krieger, a social epidemiologist at Harvard University and a co-leader of the effort.

“But the problems don’t disappear, and the suffering gets worse,” she said.

Ellen Barry contributed reporting.
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