I Ran Operation Warp Speed. I’m Concerned About Bird Flu.

Opinion|I Ran Operation Warp Speed. I’m Concerned About Bird Flu.

As Donald Trump gets ready to return to the White House on Jan. 20, he must be prepared to tackle one issue immediately: the possibility that the spreading avian flu might mutate to enable human-to-human transmission.

I was the Biden administration’s chief science officer during Covid-19. I was a co-leader of Operation Warp Speed, which began in Mr. Trump’s first term to accelerate the development of Covid-19 vaccines. I worked on the purchase and rollout of hundreds of millions of vaccines and on developing antiviral treatments. One of my jobs was to assess the trajectory of the virus.

Now I am back at my job teaching at the medical school at the University of California, San Francisco. I have been monitoring the spread of bird flu, also known as H5N1, and discussing the situation with colleagues around the country. My concern is growing.

So far, there have been no reports of person-to-person spread of H5N1, though there have been at least 55 confirmed cases of bird flu in humans in the United States, almost entirely among poultry and dairy workers. Those infections are presumed to be primarily the result of contact with animals. In addition, a child in Alameda County in California with minor respiratory symptoms tested positive for H5N1 recently; it is unclear how the child became infected. There are probably other cases out there that are not being diagnosed.

All of those cases have been mild. But a teenager in British Columbia who was infected with the virus is now critically ill. In this instance, too, it is unclear how the person became infected. But the virus showed signs that it had mutated in a way that could make it easier to transmit to another person.

If this is the case, the virus might then get enough of a foothold to begin human-to-human transmission. Further mutations could evolve that would enhance attachment to human cells. Until the British Columbia case, the recent bird flu infections in humans in North America had been limited to the eyes and nasal passages. But H5N1 can become deadly when the virus attaches to the lining of the lungs in the lower respiratory tract.