Amid an escalating bird flu outbreak spreading in the United States, federal health officials have begun to brief members of the incoming Trump administration about how they’ve responded to the crisis so far.
“We sent them all of the information on our work,” said a Biden administration health official familiar with transition briefings within the Centers for Disease Control and Prevention.
It’s the first indication that the two administrations appear to be working together to prioritize the H5N1 response.
Until now, it was unclear whether the Biden White House and Trump’s incoming health team had discussed bird flu in any transition meetings. A lack of coordination between the two groups would have huge consequences, public health officials and infectious disease experts warn. They worry that the H5N1 virus has the potential to set off another human pandemic.
“You’ve got something that’s clearly evolving here in the United States,” said Dr. Cameron Wolfe, an infectious diseases expert and professor of medicine at Duke University Medical Center in Durham, North Carolina.
Sharing surveillance information and resources is crucial to understanding and getting ahead of emerging viral threats like bird flu, said Howard Koh, a professor at the Harvard T.H. Chan School of Public Health, who was assistant secretary of health and human services for health in the Obama administration.
“These teams have a shared responsibility to prioritize continuity of operations. That means maximizing preparedness to the fullest, especially after Covid,” he said. “Anything else is unacceptable.” Koh wasn’t involved with transition teams during his time with the Obama administration.
Neither Trump nor his pick for health and human services secretary, Robert F. Kennedy Jr., has publicly suggested how the Trump administration would handle the outbreak. What’s more, Kennedy’s team has signaled it didn’t see value in seeking input from Biden health officials.
In a statement, Katie Miller, a spokesperson for Kennedy, said via text that the American people “don’t want or need the Biden administration to tell us how to do anything.”
“What would career bureaucrats who failed our nation during COVID know how to handle anything,” Miller added. “They have failed beyond measure on every national crisis.”
Need to expand testing, surveillance efforts
Working together, however, can help both teams understand the magnitude of the problem, said Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee, who was speaking generally about bird flu and not about any specific administration.
“A pandemic due to bird flu is a looming threat,” Schaffner said. “As we transition from one administration to another, coordinating public health concepts and policies is of course very important.”
At least 66 people, most of them dairy workers, have been infected. Last week, the Louisiana Health Department reported the country’s first human death from bird flu: that of a 65-year-old man who had exposure to a backyard flock.
Samples of the virus collected from the Louisiana patient showed concerning signs of mutations that could make it more transmissible to humans, although, according to the CDC, the virus hasn’t yet spread from person to person.
An estimated 925 herds of dairy cattle in 16 states have been infected with the H5N1 virus, according to the Agriculture Department. The virus has killed millions of poultry, driving up the price of eggs and causing some shortages.
Dr. Erin Sorrell, a senior scholar at the Johns Hopkins Center for Health Security, stressed the importance of expanding testing and surveillance efforts to track cases among both animals and humans, which requires complex coordination among federal, state and local officials. In early January, the Biden administration announced $306 million in funding to support bird flu monitoring and other preparedness efforts.
“If the policies aren’t carried forward, and if they are halted or paused, we are giving the virus the opportunity not only to spread to poultry and cattle — impacting those economies, those animals and the people who live and work with them — but also then encouraging the virus essentially to infect more people,” Sorrell said.
Last month, the Agriculture Department stepped up its response to the outbreak, issuing a federal order mandating testing of the national milk supply. The federal government has also issued guidance and funded outreach to help prevent the virus from spreading to farmworkers in contact with sick animals.
But such efforts need to be ramped up in the Trump administration to prevent bird flu from spreading, said David Stiefel, a former national security analyst at the Agriculture Department.
“They need to find really good ways to incentivize farmers and industry owners to test. This administration has made some good leaps and bounds, but it’s not done,” Stiefel said.
The strain of bird flu driving the outbreak began spreading globally among wild birds and poultry in 2020. It reached the United States in 2022 and has led to the infection or culling of more than 130 million birds, according to the Agriculture Department.
The virus’ spread in mammals is concerning because it gives the bird flu many opportunities to jump to people and potentially mutate in ways that spread effectively from person to person, infectious disease experts say.
Worries about vaccine hesitancy
The government has two bird flu vaccine candidates in limited quantities in its stockpile. Biden administration officials have said they have no current plans to authorize them.
Dr. Nahid Bhadelia, a former senior policy adviser on Covid for the Biden White House, said it would be critical for the next administration to continue investing in developing new bird flu vaccines and to ensure that manufacturers have surge capacity if they suddenly need to mass produce them — much as Trump administration succeeded in doing during the Covid pandemic.
However, Kennedy, Trump’s choice for health and human services secretary, has spent decades publicly opposing vaccines, raising concerns about the future of federal support for vaccine programs. In 2023, Kennedy said that if he were elected president, he would tell the National Institutes of Health to take “a break” from studying infectious diseases to focus on chronic illness, instead.
And vaccination hesitancy and refusal have also increased across the country since Covid began.
“I am concerned about coming out of the Covid-19 vaccine hesitancy and politicization and the overall anti-vaccine sentiment — I very much worry what will happen if we get another pandemic,” Bhadelia said. “It keeps me up at night.”
An HHS spokesperson said the agency and the Agriculture Department have “collectively committed $2.5 billion to prepare for and respond to the avian flu outbreak.”
“We have done our jobs day in and day out for the American people — just as we did when we delivered 700 million lifesaving shots into the arms of Americans during the Covid-19 pandemic,” the spokesperson said. “We certainly hope the incoming administration takes the avian flu threat as seriously as we have.”
