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As bird flu spreads in cows, fractured U.S. response has echoes of early covid

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Federal agencies with competing interests are slowing the country’s ability to track and control an outbreak of highly virulent bird flu that for the first time is infecting cows in the United States, according to government officials and health and industry experts.

The response has echoes of the early days of 2020, when the coronavirus began its deadly march around the world. Today, some officials and experts express frustration that more livestock herds aren’t being tested for avian flu, and that when tests and epidemiological studies are conducted, results aren’t shared fast enough or with enough detail. They fear that the delays could allow the pathogen to move unchecked — and potentially acquire the genetic machinery needed to spread swiftly among people. One dairy worker in Texas has already fallen ill amid the outbreak, the second U.S. case ever of this type of bird flu.

Officials and experts said the lack of clear and timely updates by some federal agencies responding to the outbreak recall similar communication missteps at the start of the coronavirus pandemic. They point, in particular, to a failure to provide more details publicly about how the H5N1 virus is spreading in cows and about the safety of the milk supply.

“This requires multiple agencies to coordinate and communicate internally, but most importantly externally, which doesn’t seem to be happening due to different cultures, priorities, legal responsibilities, scientific expertise, and agility,” said Katelyn Jetelina, an epidemiologist who writes a weekly infectious-diseases newsletter and has closely tracked the avian flu outbreak. “Mix that in with the usual challenges of scientific uncertainty, complexity and, quite frankly global pressure, and you got yourself an utterly, unacceptable mess.”

A senior administration official said there have been “no competing interests.” The White House’s Office of Pandemic Preparedness and Response Policy is coordinating the outbreak response with relevant agencies “that are working quickly and methodically.” The government is “committed to sharing results as soon as possible,” said the official, who spoke on the condition of anonymity to discuss internal deliberations.

“This work is an urgent priority as we work to ensure the continued effectiveness of the federal-state milk safety system and reinforce [the Food and Drug Administration’s] current assessment that the commercial milk supply is safe,” the administration official said.

Until Wednesday, testing for H5N1 in dairy herds was voluntary and limited to cows with certain symptoms. The number of tests per farm was limited, too. That protocol provoked sharp criticism from public health experts. With growing evidence that the virus is more widespread than feared among cows, the U.S. Agriculture Department announced Wednesday that lactating dairy cows must be tested for bird flu before moving across state lines, starting Monday.

Responsibility for monitoring and containing the outbreak is divided among three agencies. USDA leads the investigation into the virus in cows, the FDA oversees food safety, and the Centers for Disease Control and Prevention is monitoring risks to people.

Agencies have given individual updates on their parts of the outbreak investigation, but Wednesday marked the first time since bird flu was detected in cows four weeks ago that CDC, FDA and USDA, along with other agencies, held a news briefing jointly. On Thursday, government scientists are scheduled to present data about their investigations at a webinar hosted by state health officials.

For weeks, key federal agencies have expressed confidence in the safety of the commercial milk supply, including pasteurized products sold at grocery stores.

But it was two weeks before the FDA responded directly to The Washington Post’s questions about whether the agency was testing milk on grocery store shelves for H5N1. On Tuesday, the agency confirmed that viral particles had been found “in some of the samples,” but it declined to provide details. On Wednesday, an FDA official confirmed fragments were found in milk on shelves but declined to say how many samples the agency has tested, how many had virus fragments and where the milk originated. The testing does not indicate whether virus fragments are active or dead.

Additional testing is underway, but Donald A. Prater, acting director of the FDA’s Center for Food Safety and Applied Nutrition, said the agency has seen nothing to change its assessment that the commercial milk supply remains safe. “We also know that assessments can change as we learn more, and we will be transparent about any changes based on emerging data,” Prater said.

Officials are seeking answers to other key questions: They want to know whether the virus is spreading among cows through mechanical means, such as milking equipment, as evidence suggests, or through the air, which would be more dangerous and lead to more sustained spread. They are also interested in knowing how long livestock will shed virus in their milk once they have recovered from an infection. And, crucially, they will seek to ascertain the risks for human exposure and whether protocols are in place at the state level if additional people test positive.

The investigation “involves different types of samples, different types of studies and really being methodical about how we’re approaching answers to those questions around things like ensuring safety of the food supply,” said one senior government official who spoke on the condition of anonymity to share internal policy discussions.

“We’re not trying to pull the fire alarm here and suggest that there’s more of a risk to people than exists,” said another federal health official, who also spoke on the condition of anonymity to share internal deliberations.

The key to the outbreak resides with the cows.

Public health officials and industry experts say the USDA should be doing broader testing to paint a clearer picture of the scale of the outbreak. The government has been too slow in sharing genetic information and epidemiological studies, they said. More routine testing on herds and even other animals would reduce the risk of spreading the virus to other cattle and poultry farms, public health experts and veterinarians have said.

“Given this is a novel outbreak, testing needs to be done widely and rapidly, investigators need to be on affected farms, and scientists and policymakers need to be bringing it all together to set a coordinated plan of action,” Tom Inglesby, director of the Johns Hopkins Center for Health Security, said in an email last week. Inglesby was the White House testing czar during the Biden administration’s coronavirus response.

“This isn’t just about protecting U.S. agricultural interests,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “This is about protecting human health, protecting farmworkers that may be in harm’s way and preventing another pandemic from happening.”

Nearly three dozen livestock herds in eight states have been infected in the last month. The virus has also spread from dairy farms to poultry farms and infected barn cats. Epidemiologists fear that indicates cows can pass the virus to birds, and possibly other animals, broadening the potential for spread.

Scientists who performed genetic analyses of virus taken from infected animals say the tests suggest the outbreak may have been occurring for longer and across more of the United States than previously thought.

Michael Worobey, a University of Arizona virologist who led a team of scientists who analyzed 239 genetic sequences released Sunday by the USDA, said the evolutionary tree of the virus “resoundingly indicates that this outbreak had a single origin and that it had been circulating under our noses for months before it was noticed.”

“The concerning thing was it meant that all of these outbreaks in at least eight different states traced back to a common ancestor that had been around probably since late 2023 and that meant that this outbreak almost certainly has its tendrils all across the U.S. and perhaps beyond,” Worobey said.

Scientists trying to piece together the outbreak’s genesis said the USDA was too slow in sharing critical genetic data initially, and when “a big dump” of 239 genetic sequences arrived Sunday, it was not comprehensive.

“Like what samples they are coming from, when exactly they were collected … and where exactly they were collected,” said Angela Rasmussen, a virologist and principal research scientist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada.

Public health and veterinary experts say they also want more epidemiological data — including information on the movement of animals, their feed sources and how many workers are on-site — to understand how and where the virus is circulating.

Beth Thompson, South Dakota’s state veterinarian and president of the National Assembly of State Animal Health Officials, said such information needs to be shared quickly.

“It’s like if you just rip one page out of a chapter in a book and hand it to the states, that isn’t the whole chapter,” Thompson said. “We need all of the information to be given back to us.”

The lack of more aggressive testing of livestock and transparent data-sharing has frustrated officials at the Department of Health and Human Services, according to another federal health official and a public health expert who were briefed on the response.

USDA officials may be constrained by their mission to promote new markets for farmers and protect animal health and welfare, said an administration official who spoke on the condition of anonymity to discuss internal deliberations. “They’re just twisting themselves into knots because they’ve got two missions that are, in this instance, pointing in different directions,” the administration official said.

The official suggested the agency is operating at a level of urgency closer to a 4 when it should be a 10, the official said.

Not true, said USDA spokeswoman Marissa Perry.

“USDA’s top priority is containing this emerging animal health issue,” Perry said.

While H5N1 is typically fatal in poultry, the disease in infected cows has been relatively mild, and animals have recovered in a week to 10 days, according to agriculture officials.

The biggest challenge so far has been identifying farms willing to share samples, said Rosemary Sifford, the USDA’s chief veterinary officer. The agency has been testing sick and healthy cows in affected herds, and in recent days began testing in unaffected herds, she said in an interview last week.

The virus appears to be spreading in cows that are producing milk “and the place that those animals are most closely congregated, have the most contact, would be as they’re moving through the milking parlor,” Sifford said. “We are not seeing this virus moving outside the lactating herd.”

This strain of avian flu has been circulating for more than 20 years, but its leap into cows is of significant concern, surprising even longtime observers of the virus. While avian flu has infected humans — especially in Asia — the virus has yet to prove able to spread efficiently in people. But the more the virus jumps animal to animal, the greater the chance mutations will emerge that allow sustained person-to-person transmission, the required next step for a pandemic.

State health officials have tested at least 23 people; only the dairy worker in Texas, who has since recovered, was confirmed positive. Ongoing surveillance of emergency department visits and flu testing results in regions with bird flu have not identified any unusual or concerning patterns, the CDC’s principal deputy director, Nirav Shah, said Wednesday. The risk to the public from bird flu remains low.

For dairy farmers, the potential impact on their business is top of mind.

“Lots of farms aren’t raising their hands to be tested because they don’t want to be known as having an infected herd,” said Keith Poulsen, director of the veterinary diagnostic lab at the University of Wisconsin-Madison.

Jamie Jonker, chief science officer for the National Milk Producers Federation, described as appropriate the USDA announcement on testing and interstate movement. But milk producers are waiting for the USDA’s detailed guidance to know how many tests may need to be performed on milk cows, estimated to number about 8 million, Jonker said.

The testing mandate could help overcome reluctance from some milk producers to allow testing in their herds, the USDA’s Mike Watson said Wednesday. The cost of mandatory testing would be reimbursed by the agency.

A wide swath of federal agencies are mobilizing in the event the highly pathogenic virus evolves.

At highest risk are farmworkers, who, like many in the agriculture sector, are undocumented or do not wish to interact with the government, Shah said.

In an emergency call three weeks ago with state health and lab officials, Shah laid out a detailed list of operational questions state officials needed to answer to prepare for potential exposures in people.

“What nurse and what epidemiologist have you trained up to do this? Do you have the [nasal] swabs ready? Do they know how to approach that conversation in a culturally competent and linguistically competent manner? … Is the lab ready to go?”

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What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

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Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

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Here is how to prepare your online accounts for when you die

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LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

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Pediatric group says doctors should regularly screen kids for reading difficulties

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The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

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