California has declared a state of emergency. The bird flu could become a global pandemic.

Bird flu has been high on the global worry list of potential pandemics for decades. Now the fear can become reality.

A so-called highly pathogenic variant of H5N1 avian influenza (2.3.4.4b) has spread around the world in the past three years. In Rogaland, tens of thousands of commercial poultry have been culled due to several outbreaks of infection during the period. And last summer it rained dead birds from the sky in Finnmark.

Worldwide, dead wild birds have been reported in 79 countries and from 315 different species — some of them hit so hard they are put on red list.

In March this year, this H5N1 virus made the leap from bird to cattle in the United States. Now, just over six months later, the infection is found among cattle in 16 states. In California, over half of all cattle herds are affected, and Governor Gavin Newsom declared late Wednesday night a state of emergency in the state.

Infection has also been detected in a number of other mammals, both wild and domesticated, from house mice and cats to dolphins and polar bears. The development is disturbing. It shows that the virus is becoming increasingly better adapted to infection in new species. Including people.

Practicing on people

In the United States, it appeared first case of infection in humans increased in April this year. Since then, the number of confirmed cases of infection has increased exponentially.

In the latest count in the United States, the number has passed 60, a doubling in less than two months. Most of these are infected after contact with animals, especially cattle. But in recent weeks, a couple of infection cases with unknown source have also emerged, including two children. It suspected that they may have contracted the infection through colostrum.

Infection in animals and humans is probably even more widespread than the official infection statistics show. The virus has now been detected in samples from wastewater across the United States, from New Jersey to Texas -- Even in Hawaii.

The more contagion, the more chances the virus has to adapt to humans.

The big question is: What does it take for the bird flu to spread between people and create a pandemic? The answer is, we don't know. But scientists warn in a recent paper that we could be as little as one mutation away.

Why don't we do more?

In Canada a teenager lies in the ICU, infected with a virus variant quite similar to the one we fear. Is it a matter of time before it breaks loose?

Infection control authorities in the United States believe the public health risk remains low. Other professionals, on the other hand, believe that a pandemic may be imminent: “If H5N1 will ever become a pandemic, it is now”, says a flu researcher to the journal Science.

Same message we can now find in newspaper headlines over the entire world.

A recent report on global health from the Stoltenberg Committee states that The corona pandemic was not the wake-up call we needed to prepare the world for the next pandemic. And it's going to happen again.

In a recent Lancet article Scientists estimate that there is a 23 percent risk that in the next ten years we will have a pandemic that will kill at least 25 million people.

Why don't we do more to strengthen our preparedness? It is particularly disappointing against such a severe and visible backdrop as what bird flu is, which could potentially have higher mortality rates than covid-19.

It's urgent

Despite this dire situation, Norway is still outside the EU health community. During the corona pandemic, it was Swedish goodwill that secured Norway access to vaccines through the EU Procurement Scheme. Should we really gamble on the EU being just as merciful next time, as suggested by Trygve Slagsvold Vedum (Sp) in Politisk Kvarter on November 28th?

That would be indefensible policy, and fortunately Health Minister Jan Christian Vestre (Ap) has higher ambitions. He wants to put in place as soon as possible a cooperation agreement with the European Union on countermeasures in health crises. The problem is that the process is far too slow.

On questions from the Liberal Party in Parliament Vestre replies that they hope to get the negotiations started in the spring. By then, it may be too late. With the worrying developments of bird flu we are seeing now, we may have a pandemic on our door before Easter. Norway must use all its diplomatic weight to speed up the process.

In parallel with the EU cooperation, Norway must also strengthen its international work on vaccine development.

The Norwegian initiative Cepi (Center for Epidemic Preparedness Innovations) aims to develop new vaccines within 100 days. It is necessary when we are dealing with viruses that mutate rapidly and cause emergency stocks of vaccines to quickly become outdated. Just like with the flu vaccine, we need to be able to update the vaccines in line with new virus variants.

Critical test

Over the New Year, the government is expected to submit a general emergency notification to the Storting. It will be a critical test of the government's willingness to take the pandemic threat seriously.

Expert communities and the Directorate for Community Safety and Preparedness (DSB) are unanimous that the very greatest risk to society comes from biological threats.

The experience of COVID-19 clearly showed that a pandemic not only affects public health — it also crippled the economy and tore apart our social life.

We are now at a crossroads. California did not declare a state of emergency without cause. Either we act resolutely and strengthen both European and international cooperation, or we risk being left unprepared when the next pandemic strikes.

In this race against the clock, we have no time to lose.