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A test tube with a blood test for h5n1 avian influenza. The concept of an avian flu pandemic. Checking the chicken for diseases.
The first human death from bird flu in the United States occurred on January 6 in a Louisiana hospital, less than three weeks before the second Donald Trump administration’s inauguration. Bird flu, also known as Avian influenza or H5N1, is a disease that has been on the watch list of scientists and epidemiologists for its potential to become a serious threat to humans.
COVID-19’s chaotic handling during Trump’s first term serves as a stark reminder of the stakes. According to the Centers for Disease Control (CDC) and Prevention, last year, 66 confirmed human cases of H5N1 bird flu were reported in the United States. That is a significant number when you consider that only one case was recorded in the two previous years.
Bird flu was first detected in domestic birds in 1996 in Southern China and has since spread to wild birds, mammals, and humans worldwide, with a fatality rate reaching 50% in some cases. In the U.S., cases have been mostly mild, affecting primarily poultry and dairy workers, until this recent death in Louisiana.
In the spring of last year, bird flu showed up in cows. When a pathogen—any organism that causes a disease—jumps species, scientists get nervous because its genetic makeup can reconfigure and become more transmissible or lethal. The fact that humans are now being infected is a red flag. Though human-to-human transmission of H5N1 has not yet happened, it does not mean it can’t.
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“That’s our concern — the more shots on goal that we give the virus, the greater chance of there being a mutation of some sort that precipitates a much larger situation,” said Dr. Nirav D. Shah, principal deputy director of the CDC. “But we’re also equally interested in the scientific finding that thus far, in the current outbreak, cases have been milder than what we’ve seen historically.”
Since the health of animals is directly linked to that of humans, the federal government took swift action. In a joint op-ed in USA Today, Xavier Becerra, secretary of Health and Human Services, and Tom Vilsack, secretary of Agriculture, said, “As heads of the federal departments responsible for human health and animal health, we quickly stood up a coordinated response organized around four key priorities: monitoring and stopping transmission, protecting workers and the public, keeping animals healthy and ensuring the safety of our food supply.” Drinking raw milk, for instance, is especially risky now.
The key question is whether the new administration has the political will to prioritize Americans' health. Trump’s nominee to lead Health and Human Services, Robert Kennedy Jr., is a vocal vaccine skeptic critical of federal mandates during the COVID-19 pandemic. Similarly, Dr. Dave Weldon, the nominee for CDC, has questioned the efficacy of vaccines and public health measures to control disease outbreaks.
For an in-depth conversation on the role of Health and Human Services, listen to this 1A podcast episode with host Jenn White by clicking HERE.
Rebecca Katz, Director of the Center for Global Health Science and Security at Georgetown University and author of The Outbreak Atlas, reminds us that bird flu is the latest threat to human health. This past year alone, the world witnessed a Marburg virus outbreak in Rwanda, Mpox in central Africa, and a resurgence of measles worldwide, primarily driven by diminished confidence in childhood vaccines.
“There are death, taxes, and emerging infectious diseases. You can guarantee that there will be more diseases,” Katz told the Fulcrum, adding there is a collective tendency to pivot from cycles of panic to neglect. “We had the biggest generational disease event five years ago. Now, we are in the biggest valley of neglect. There's no money, no workforce, and no confidence. We're going to have to fix that.”
On January 3, President Joe Biden’s administration announced US$ 306 million in additional funding for the H5N1 response. However, experts such as Katz believe there are still insufficient resources allocated towards long-term pandemic preparedness. Despite the likelihood of future outbreaks, Trump has suggested disbanding the Office of Pandemic Preparedness, established in 2022, which would hinder coordinated national responses. Making childhood vaccines optional could further erode collective immunity and prompt insurers to stop covering them.
“The reason why vaccines are so readily available to people is because of the Affordable Care Act and the vaccine for children program,” said Sam Bagenstos, former General Council to HHS under President Biden, on the 1A show aired January 8 on NPR. “If the CDC Director were to take vaccines off that list, vaccines would instantly become effectively unavailable to most people in the country. There is a very substantial risk that even without taking away the approval of vaccines, even without any regulatory changes, a new administration could make it much harder for people to get vaccinated.”
Managing outbreaks, says Katz, is complex and requires coordination at all levels. While the CDC, as a federal agency, is tasked with the genetic sequencing of a virus, two things must be prioritized locally: disease surveillance and public awareness. However, “if I had to pick one priority investment, it would be people,” says Katz. “I am deeply concerned about our workforce. We don't have enough people, and the ones we have are not sufficiently supported to be able to do their jobs effectively.”
The lack of trust and outright threats directed at U.S. medical personnel and public health officials at the height of the pandemic prompted many to resign, leaving behind a demoralized and weaker workforce. Mistrust is fueled by rumors and inaccurate information. But disinformation, which is false and deliberately intended to mislead the public, plays an even greater role in undermining trust.
The Outbreak Atlas, co-authored by Katz and Wellcome Trust scholar Mackenzie S. Moore, uses global case studies to explain outbreak preparedness, response, and recovery. It aims to educate people with the tools to make informed decisions during disease outbreaks, regardless of federal actions.
“I'm a professor, so I believe in increasing public literacy,” says Katz. “The more people know, the more they're able to understand, the better they're able to digest and make sense of the information that comes out around the next threat.”
Incoming administration officials would be wise to read The Outbreak Atlas. When George W. Bush was president, he urged his top officials to read The Great Influenza by historian John M. Barry, recognizing the need for a national strategy to prevent another catastrophe like the 1918 flu pandemic. His foresight was a model of preparedness. Why wait for bird flu—or any other infectious disease—to spiral out of control when the time to act is now?
Beatrice Spadacini is a freelance journalist who writes about social justice and public health.
Illustrative picture showing application for USA H1B visa
Elon Musk and Vivek Ramaswamy both came out recently in favor of expanding the H-1B visa program. This program allows large corporations to claim they cannot find adequate skilled talent (engineers for example) and sponsor a foreign worker to enter the United States to fill the required role.
The program itself is rife with abuse and inevitably and negatively affects American citizens by adding to the supply of talent and inevitably decreasing the price of such talent (wages).
Some disagree with Musk and Ramaswamy. Many identify as MAGA and argue that it is counter to Trump's desire to limit immigration. Yet Trump himself has said he supports the H-1B program. He has also recently said that foreign students graduating from American universities should automatically qualify for a Green Card (permanent residency). This would allow them to work without needing a visa and put them on the path to naturalized citizenship.
Ramaswamy included commentary on American cultural failings in not producing enough home-grown talent. Musk used a sports metaphor to argue that bringing in foreign talent was necessary to keep the U.S. on top economically. While these arguments have elements of truth, they also fail to consider some key points.
For some context on this opinion, I wrote early in 2024 that we should stop all immigration for an extended period, including H-1B visas, while we fixed the mess we were currently in, and have a national debate about how immigration should be handled going forward. I stand by that opinion, as well as my suggestion for a kinder and gentler mass deportation. While I am pro-immigrant, I believe these steps are necessary for a cultural and policy reset. As beneficial as immigration has been to our shared history, our current policy is polarizing us from many directions while failing to make America better.
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Ramaswamy’s commentary on cultural failings is not wrong though they could also be defined as educational shortcomings. That is on us as parents (and grandparents), and our political and business leaders to fix. The H-1B program not only ignores those problems but gives us a seemingly cheap way out to avoid fixing them.
I have low expectations that politicians or our universities will fix this problem. However, I have high expectations that big business could fix the problem if the H-1B program were unavailable. Simplistically speaking, they could hire young technology interns, give them on-the-job training, sponsor their advanced education, and meritoriously promote and pay the best.
Musk meanwhile decided to clarify his position, stating that he only wanted to bring in the top 0.1% of talent from foreign countries. However, these arguments assume that economics is a zero-sum competition between nations. In his world, H-1B becomes a weapon of economic war in our effort to stay on top.
Essentially, Musk is suggesting we use H-1B not just to advance our economy but to debilitate other countries in their effort to advance their economies. And in doing so we inevitably hurt ourselves.
What happens when other nations (especially so-called third-world nations) advance economically and educationally? Does it cause us damage? On the contrary, in a free trade environment, when other nations become stronger economically, they become bigger markets for American-made goods and services. They also provide quality, cost-effective goods and services to Americans. And robust economies create a more cooperative and peaceful world. Buying and selling with each other is more advantageous than waging actual war.
Don’t get me wrong. I am a died-in-the-wool capitalist (actually a “free-marketist” but that is a subject for another day). I believe competition between market participants is good. And yes, it often results in creative destruction when some firms fail while others are born. But the competition should be among those market participants and not among nations.
Let’s not wage economic warfare to paper over our internal problems. Put the H-1B program on ice and fix those problems instead.
David Butler is a husband, father, grandfather, business executive, entrepreneur, and political observer.
A barn burning during a wildfire.
The devastation caused by the recent fires in Los Angeles has been heartbreaking. The loss of life and property, and the grief that so many are experiencing, remind us of the vulnerability of everything in life.
Nothing is permanent. There are no guarantees for tomorrow. We are all so fragile and that fragility so often leads to breaking. And it hurts.
If there's a bright spot, it's this: the devastation has unleashed enormous generosity and solidarity of people in Los Angeles and around the country toward those who are most wounded by the devastation.
First responders are risking their lives, friends are taking each other into their homes, volunteers are bringing food and clothing to those most affected, and people from around the country and around the world are giving. Pain experienced by so many is being met by love given in equal measure.
My brother told me he'd heard from dozens of friends from long ago who he'd thought had forgotten about him. As devastating as it is to watch the destruction, the silver lining is to watch human beings respond with so much compassion.
As hard as it is to make sense of all this, we're blessed by a voice of help coming to us at exactly the right moment. Just this week, our nation's Surgeon General, Dr. Vivek Murthy, published his final prescription for healing our country, and it couldn't be more timely. "Choose community," Dr. Murthy writes, because "relationships, service and purpose create an ecosystem of meaning and belonging that are essential for fulfillment."
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In short, the Surgeon General is telling us that if we want to be healthy and heal, we need to strengthen the work of building community, and we have to root that work in the transformative power of love and connection. It's as though Dr. Murthy wrote this letter for all of us right now.
Like many of you, I’ve been looking for ways to help, to offer support, and to find meaning in a tragedy that defies understanding.
For those of you wanting to help those impacted by the fires, my sister Maria and her team have compiled this list of vetted organizations that need support.
For me, this tragedy hits close to home. Several of my own family members have been directly affected—my brother, my sister, my daughter, my nieces and nephews, and several cousins have all been forced from their homes, uncertain about what lies ahead. I know I’m not alone in this, as so many of you are also grappling with the enormity of what has happened.
In this spirit of community, I know you all join me in working on how we can foster hope and healing—not only for those on the front lines but for all of us as we navigate this crisis and all the stress of these times. We can all do our part: make the extra call; let others know you care; offer whatever gifts you have; and give whatever you can. Nothing is too small and everything counts.
Above all, commit to strengthening the bonds that bind us together as family, as people of faith, as country. If ever the message was clear, it's clear now: community isn't just a vague idea or a long-term goal: it's survival.
In the spirit of community and love,
Tim
Tim Shriver is the chairman of Special Olympics, founder and CEO of UNITE, and co-creator of the Dignity Index. Visit dignity.us to join Tim’s newsletter mailing.
Palestinians gather to celebrate after the announcement of an cease-fire agreement between Israel and Hamas in Ramallah, West Bank on January 15, 2025.
WASHINGTON— On Wednesday, both U.S. President Joe Biden and President-elect Donald Trump took credit for a ceasefire-for-hostages agreement related to the conflict in Gaza. This deal, which had been in the works for several months, received additional support from an envoy associated with Trump, helping to facilitate its completion.
In announcing the ceasefire, Biden noted the final deal largely mirrored the framework of a proposal he made back in May, Reuters reported. He smiled when a reporter asked who the history books will credit for the ceasefire and asked, "Is that a joke?"
In a social media post, Trump promptly asserted that he deserved some credit for the recent breakthrough, which followed months of stalled negotiations. He had previously expressed strong concerns, stating there would be "hell to pay" if a deal wasn't reached before he assumes office on Monday.
"This EPIC ceasefire agreement could have only happened as a result of our Historic Victory in November, as it signaled to the entire World that my Administration would seek Peace and negotiate deals to ensure the safety of all Americans, and our Allies," he said.
Reuters reported that Trump had dispatched his Middle East envoy, Steve Witkoff, to join the negotiations in Doha, and Witkoff was there for the last 96 hours of talks leading up to the deal.
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A senior official from the Biden administration, during a briefing with reporters, acknowledged Witkoff's contributions to facilitating the deal, noting his collaboration with Biden's envoy, Brett McGurk, who has been in Doha since January 5.
The cease-fire will be implemented in two phases. The first phase, expected to last approximately six weeks, involves a complete cease-fire, the withdrawal of Israeli forces from all populated areas in Gaza, and the release of several hostages held by Hamas, including women, the elderly, and the wounded.
Israel has also released hundreds of Palestinian prisoners, Biden said, and Palestinians "can also return to their neighborhoods in all areas of Gaza, and a surge of humanitarian assistance into Gaza will begin." The second phase of the cease-fire will begin after Israel negotiates "the necessary arrangements," which Biden said would mark "a permanent end of the war,” Fox News reported.
Jonathan Panikoff, director of the Scowcroft Middle East Security Initiative at the Atlantic Council, told the Associated Press that Biden deserves praise for continuing to push the talks despite repeated failures. But Trump’s threats to Hamas and his efforts through Witkoff to “cajole” Netanyahu deserve credit as well, he said.
“The ironic reality is that at a time of heightened partisanship even over foreign policy, the deal represents how much more powerful and influential U.S. foreign policy can be when it’s bipartisan,” he said. “Both the outgoing and incoming administration deserve credit for this deal, and it would’ve been far less likely to happen without both pushing for it.”
Israeli President Isaac Herzog expressed his appreciation to both the incoming and outgoing U.S. presidents.
According to a senior U.S. official involved in the negotiations, the agreement implementation could start on Sunday, when the first group of hostages might be released.
