Inside the Bungled Bird Flu Response, Where Profits Collide With Public Health (2024)

PUBLIC HEALTH

When dairy cows in Texas began falling ill with H5N1, alarmed veterinarians expected a fierce response to contain an outbreak with pandemic-sparking potential. Then politics—and, critics say, a key agency’s mandate to protect dairy-industry revenues—intervened.

By Katherine Eban

Inside the Bungled Bird Flu Response, Where Profits Collide With Public Health (1)

Photograph from Getty Images.

“Everything Was on the Down Low”

The US Department of Agriculture’s headquarters are situated on a tony stretch of DC real estate, a world away from the nation’s farms. So when something goes seriously wrong on America’s plains and pastures, something that could threaten animal safety or food production, USDA officials rely on rural veterinarians to sound the alarm.

Those vets report findings to state veterinarians, whose doors and inboxes are always open. They even post their cell phone numbers online. The state veterinarians, in turn, utilize a network of diagnostic laboratories approved by the USDA, chief among them the National Veterinary Services Laboratories (NVSL) in Ames, Iowa.

This close-knit network, with built-in redundancies, is primed to tackle the awful and unexpected, whether it’s foot-and-mouth disease, swine fever, or an act of agroterrorism. There’s little standing on ceremony, and state veterinarians generally feel free to reach out directly to leading USDA officials. “If we want information, we go up the chain to the top,” says Beth Thompson, South Dakota’s state veterinarian.

That, at least, is how it’s supposed to work. It’s how veterinarians responding to dairy farms in the Texas panhandle earlier this year assumed it would work when they stumbled upon hellish scenes out of a horror movie. Feverish cows in respiratory distress producing trickles of milk. Dying cats. Enough dead barn pigeons and blackbirds to suggest a mass poisoning. Living birds with twisted necks, their heads tilted skyward.

Worried vets enlisted help from colleagues in other states. In mid-March, one sent an email to an emergency address at the NVSL, urging the lab to test for something seemingly unthinkable: highly pathogenic avian influenza, which had never before been detected in cows.

Days went by in silence. Finally, on March 25, the USDA lab confirmed that dairy cows in Texas and Kansas had indeed been sickened by a form of bird influenza known as H5N1. Though versions of the so-called bird flu virus have circled the globe for almost two decades, spreading to species ranging from pelicans and polar bears to sea lions and skunks, the announcement stunned the scientific and agricultural communities. “Every honest virologist will tell you: We did not see this coming,” says Kimberly Dodd, dean of Michigan State University’s College of Veterinary Medicine.

“We plan for every agricultural health emergency, but all of our red teaming missed this” scenario: an agricultural outbreak that potentially imperils public health and leaves cows sick but mostly still standing, says David Stiefel, a former national security policy analyst for the USDA.

With continued spread amongst cows, or to another “mixing-vessel” species like pigs, the virus “could mix and match, then you get a whole new genetic constellation,” says Jürgen Richt, regents and university distinguished professor at Kansas State University. Experts are hesitant to speculate about what could happen if the virus were to begin more widely infecting humans, for fear of spreading panic, but the toll could, in the worst case, dwarf that of COVID-19. If the virus “infects a person infected with a human flu strain, and something comes out that is reassorted and adapted to humans? I don’t even want to imagine,” Richt says. “Not good.”

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The Institute for Disease Modeling, a research institute within the Bill & Melinda Gates Foundation, has estimated that a global flu pandemic could kill close to 33 million people within six months.

At that existential moment back in March, when the virus was first detected in cows, veterinarians involved in the response had every expectation that a well-honed network of experts, led by USDA scientists, would immediately rev to life.

But it didn’t. “Nobody came,” says one veterinarian in a Western state. “When the diagnosis came in, the government stood still. They didn’t know what to do, so they did nothing.”

Now, H5N1 has spread to more than 324 dairy herds in 14 states and has sickened at least 26 farm workers exposed to infected cows and poultry. Those numbers are widely assumed to be vast undercounts, as there is no formal nationwide surveillance program, many dairy farmers oppose testing, and few farm workers are being screened.

Courtesy of Crystal Heath DVM.

While there are no known human fatalities, and the infections in people have been mild so far, the toll on cows appears to be intensifying. In California, farmers have reported that up to 15% of sickened cows have died—a mortality rate significantly steeper than in other states. As for humans, the FDA has warned that raw, unpasteurized milk may pose a health threat, though pasteurized milk is safe to drink.

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This should be a story of heroism, cooperation, and an all-hands effort to defeat a wily virus that many scientists warn could mutate into a pandemic threat. Instead, it is a story of intimidation and obfuscation. The vets who sounded the alarm have been silenced, some even fired, and won’t discuss their experiences on the record for fear of reprisals. And the federal agency that was supposed to help thwart the virus instead has allowed for an unspoken “don’t test, don’t tell” policy among dairy farmers.

The USDA’s inaction, critics say, is attributable to its dual—and sometimes conflicting—mandates. It is responsible for the health and safety of the nation’s food animals, but it’s also in charge of promoting and protecting America’s $174.2 billion agriculture trade. And sick cows, with documented cases of a virus never before seen in cattle herds, could be very bad for business.

Shortly after the March 25 diagnosis, rather than urging transparency and cooperation, the USDA imposed an effective gag order on its employees, Vanity Fair has learned. On April 10, state veterinarians and diagnostic officials began getting furtive phone calls from longtime colleagues at the Animal and Plant Health Inspection Service (APHIS), the USDA division responsible for protecting the nation’s livestock from diseases. Calling from personal cell phones, they confided that they’d been muzzled by their own agency.

“They had been told to not discuss, not engage, to discontinue” even routine conversations with health officials in the field, “unless agendas and talking points were given prior clearance,” one state veterinarian says of the back-channel calls.

“The functional intent was, nobody was allowed to talk to anyone,” says a Midwestern veterinary specialist. “That’s when our phones started ringing. That’s when we started putting it all together. It became very clear: Everything was on the down low, and that really hampered the response from the very beginning.”

Eric Deeble, the USDA’s deputy under secretary for marketing and regulatory programs, says of the perceived information clampdown: “If anything, it was an effort to ensure that the agencies were coming together, speaking with a single voice, regardless of who we were talking to. I guess to some folks that might have felt restrictive, but it wasn’t.”

In a statement, a USDA spokesperson said that “immediately following” confirmed detection of H5N1 in dairy cows, the agency began collaborating with the Department of Health and Human Services to better understand the virus and help halt its spread. Those efforts “have allowed us to protect farmworkers and farmers, the health and welfare of livestock animals, and reaffirm the safety of our nation’s food supply,” the spokesperson continued, adding that the USDA was leaving “no stone unturned in the fight against H5N1.”

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For this report, Vanity Fair interviewed more than 55 people, including officials from the Centers for Disease Control and Prevention, the USDA, HHS, and the White House.

“The Concerns Are Business Concerns”

In the wake of the badly bungled federal response to COVID-19, the Biden administration took steps to guarantee a swifter and more coordinated response to future outbreaks. In June 2023, it established the Office of Pandemic Preparedness and Response Policy (OPPR) and appointed the retired major general Paul Friedrichs, a former military doctor with a decades-long career in biosecurity preparedness, as director.

But when a black swan scenario materialized this spring—an unprecedented bird flu outbreak in dairy cows, originating in Texas, during an election year in which absolutely no one wants to talk about scary viruses—Friedrichs faced a jumble of state and federal agencies with overlapping jurisdictions. The Food and Drug Administration regulates milk, the CDC handles human infections, and the USDA oversees cows and farms, which are often staffed by undocumented immigrants who may be reluctant to interact with government officials. On a call with scientific experts this spring, Friedrichs said that holding “grown men in my arms while they died” in Iraq was easier than coordinating the federal response to the H5N1 outbreak.

Friedrichs tells Vanity Fair that the interspecies nature of the outbreak makes combating it a unique challenge that “requires a different response” from that of COVID-19. “We’re focused on protecting human and animal health, as well as [the] food supply.”

Perhaps the biggest wild card has been the USDA’s other mandate, to serve as the government’s chief dairy lobbyist. The agency’s secretary, Thomas Vilsack, 73, previously served as president and CEO of the US Dairy Export Council. At the recent World Dairy Expo in Madison, Wisconsin, he deflected a reporter’s question about whether he planned on rejoining the dairy industry after stepping down as secretary, telling reporters: “Nobody can promise where they’re going to be tomorrow.”

According to Jason Paragas, former director of innovation at the Lawrence Livermore National Laboratory, the USDA is “designed to support industry.” Its scientists—a number of whom departed during the Trump administration, weakening the agency’s analytic heft—are “trying to support science in a nonscientific organization.”

Looming over the USDA’s reluctance to conduct a more transparent and proactive campaign against H5N1 in dairy cows are export agreements worth more than $24 billion each year, which include 2.6 million tons of milk, cheese, and ice cream, not to mention more than 5 million tons of poultry and beef. For years, poultry trade agreements have stipulated that the birds be free of H5N1. No one ever considered that such a caveat was needed for the dairy and beef agreements.

If those products were to be returned to US markets, it could shrink key agricultural industries and threaten American jobs. “The fear boils down to: How will this affect us in trade?” says Alan Young, chief technology officer for Medgene, an animal-vaccine company. “Nobody knows what the effects are, but the concerns are business concerns.”

Rather than moving forcefully to contain and eradicate the virus in dairy cows, critics say, the USDA has tried to control the narrative and spread the message that everything is just fine, actually. In June, Eric Deeble of the USDA told scientific experts on a private phone call, “In the words of the secretary, ‘It’s just going to burn itself out,’” according to an attendee’s handwritten notes, which were obtained by Vanity Fair.

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That phrase, says Deeble, a large-animal veterinarian by training, is commonly used among farmers to describe taking steps to clear a disease within a herd. He adds that it was “really a determination that USDA believes, and continues to believe, that we can eliminate this disease.”

However, in a worrying development, Missouri public health officials are investigating the case of a patient with no known exposure to susceptible animals who tested positive for the virus in late August. A close contact of that patient, as well as six health care workers who treated them, developed similar symptoms but weren’t tested at the time. The news raised fears that, having had the chance to mutate for months among thousands of mammals, the virus could be developing the ability to jump from cow to human, or from human to human—which could, in turn, spark a pandemic.

How exactly H5N1 is spreading between farms remains unclear. But the longer the virus “sits and spins and has an opportunity to jump back and forth between mammals and birds and people,” the greater the risk that it will become transmissible among humans, says Tom Halbur, chief operating officer of Medgene.

“We are seeing a very dangerous virus doing new things in a wide-open space,” says Dr. James Lawler, associate director of the Global Center for Health Security at the University of Nebraska Medical Center. “It’s a ticking time bomb. It is probably not going to detonate. But right now, we are deciding not to look at the alarm clock and wiring attached to the device and just praying it doesn’t go off.”

Says Rick Bright, former Health and Human Services deputy assistant secretary for preparedness and response: “This didn’t have to be a nationwide outbreak, but there was an intentional decision made by USDA, and the agricultural lobbying groups, to let it rip.”

Very Different Playbooks

When news of the H5N1 cases reached the White House, Friedrichs and other officials there began laying out an aggressive plan to counter the threat.

According to draft documents obtained by Vanity Fair, the plan included commissioning an “on-the-ground study of farms and infected animals” and urging “farmers, industry, and local and state agriculture and public health” officials to grant access to affected areas. The documents advised the USDA to take “aggressive biosecurity measures” to contain the virus, including ensuring surveillance of any livestock at risk.

But it soon became clear, as an administration official tells Vanity Fair, that Friedrichs’s OPPR and Vilsack’s USDA were reading from very different playbooks. The former was planning a public-health-directed response, while the latter was prioritizing the needs of the dairy industry.

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A senior administration official denies this, saying the USDA has been a “critical player in outreach and communication.” The official adds, “Secretary Vilsack himself has made 25 personal calls to governors, advocates, and partners in industry to stress the urgency” of responding to the outbreak.

In April, a former USDA official says, there was an “uproar from industry.” Dairy representatives began calling their USDA contacts to sound the alarm that the White House was reaching out to them directly, without looping in the agency that was their champion and protector. Concerned that the White House was trying to circumvent them, USDA officials began circling the wagons.

According to the former USDA official, the White House alienated the agency by pushing too hard: “I think there was some very aggressive hand-waving at the beginning that made [the USDA] less inclined to assist.”

The agency also faced a stark reality, says the former official: “Everything they do relies on farmers, industry, and state and local officials letting them in.”

On April 10, five days after the White House meeting, state veterinarians began getting calls from their USDA contacts saying they had been directed to cut off communications. Even routine biweekly calls with USDA veterinary services were suspended.

On April 15, three national veterinary organizations wrote a letter to Secretary Vilsack, which Vanity Fair obtained, urging the agency to be transparent:

One way communication will not be effective in uniting regulatory and industry partners to mitigate and control the outbreak. Please encourage open communication, solicit feedback in the creation of guidance, allow access to data and results and continue to allow this coalition unfettered access to our APHIS and [Veterinary Services] Field Staff.

It took Vilsack more than a month to write back, saying that he was “absolutely committed to timely, accurate, ongoing and coordinated communications about this situation.”

By then, as more dairy cows fell ill, even some White House staffers suspected the USDA of protecting milk sales at the expense of public health.

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In a statement, a senior administration official refuted this notion, saying the USDA immediately activated its state networks and laboratories, deployed epidemiology teams to six states on request, required testing of cows moving across state lines, and launched new programs to support dairy farmers. In addition, the HHS Administration for Strategic Preparedness and Response has provided farm workers with protective equipment and ramped up production of human vaccines, says a spokesman there.

While it is hard to ever be “fully satisfied” with any outbreak response, says Cyrus Shahpar, OPPR’s director for pandemic and biological threats intelligence, “we take this seriously.”

“That’s How the Livestock Business Goes”

On any given day, thousands of the nation’s 9.3 million dairy cows cross state lines to be raised, milked, fed, or slaughtered. Their movements ebb and flow based on factors including the shifting seasons and the fluctuating price of feed.

In late March, it fell to Texas state veterinarian Lewis “Bud” Dinges to decide whether to halt the traffic of cows back and forth across state lines. Scientifically speaking, the correct choice was obvious, says Bryan Richards, emerging disease coordinator at the US Geological Survey’s National Wildlife Health Center. “The very core tenet of disease management is to not move it around, right?”

But Dinges declined to act, and cows soon carried the virus to other states. “We could have stopped this literally in its tire tracks in April,” says Richards. “We didn’t.”

Texas agriculture commissioner Sid Miller, who is reportedly on the short list to be US agriculture secretary if Donald Trump is reelected, takes the view that H5N1 is “not a big deal. It’s not even a little deal. It only affects 10% of the milking cows. I don’t even know anyone who lost a cow.”

Even as the cows kept moving, Miller refused CDC help to test exposed workers on Texas’s farms. “This was not going to end well,” he says, comparing the government’s plans to “show up on a dairy farm unannounced” and “stick a needle in all the employees” to the 2014 Cliven Bundy fiasco, when a Nevada rancher incited an armed standoff with federal officials who sought restitution for unpaid grazing fees.

The CDC’s principal deputy director, Nirav Shah, says that while the CDC did not deploy a team on-site, “we offered to send folks to support whatever types of endeavors Texas wanted support with: testing, laboratory assistance, epidemiology, data support. We opened our doors.”

On April 24, the USDA issued a federal order for limited interstate testing. Any farmer seeking to move lactating cows across state lines had to submit negative test results for 30 cows from a USDA-approved laboratory. But herds on the move often contain hundreds of cows, and the veterinary community was soon whipped by rumors that farmers were gaming the tests by prescreening their cows in private labs to determine which were healthy.

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The Texas Animal Health Commission, which declined to make Dinges available for an interview, acknowledged that it did not restrict the movement of lactating dairy cattle on infected farms until after the federal order went into effect.

The level of vigilance has varied widely from state to state. This summer, Colorado determined that more than half of its 106 dairy herds had been infected, but that’s because it was looking. It became the first state to mandate the testing of milk in bulk tanks, where farms hold pooled milk.

In late August, the virus landed in California after cows from the state were shipped to Idaho and then sent back home. A spokesman for the California Department of Food and Agriculture tells Vanity Fair that the strain of the virus found there most closely matches the one from Idaho, though an investigation is ongoing. If the California cows were infected in Idaho, then it seems clear that the federal order on interstate testing has been insufficient in stopping the spread.

Says Idaho’s state veterinarian, Scott Leibsle, “That’s how the livestock business goes. We’re trying to keep our industries viable, and sometimes we find ourselves walking a tightrope with our regulations so they don’t restrain commerce but safeguard animal health.”

The virus is now ripping through California, the nation’s largest dairy producer, with 1,100 herds. As of late October, 124 dairy herds in the state have been infected. With the outbreak intensifying, photographs have circulated of dead cows piled outside dairy farms.

“Everyone Is So Scared Shitless”

As the virus continued to proliferate—in Michigan, New Mexico, Ohio, Idaho, and beyond—fear spread with it. At least five veterinarians who had been outspoken, or simply principled, in responding to the outbreak, were fired from their jobs, Vanity Fair has learned.

One, who had initially been asked by her employer, an animal-health company, to speak publicly about the outbreak, was suddenly told she was a risk to the company’s shareholders. She was threatened with unpaid leave, then fired. Another veterinarian who had advocated for exposed farm workers was let go. Yet another, who refused, prior to the federal order, to give manifestly sick cows a clean bill of health, was also fired.

As word of the dismissals spread, rural veterinarians who had initially spoken with the press became unwilling to go on the record, fearful it would damage their reputations and employment prospects within the tight-knit communities they served.

Rural veterinarians today face a bleak landscape that is far from the cheery scenes of All Creatures Great and Small, the James Herriot book recently adapted by Masterpiece. Burdened with a crushing workload, veterinary school debt, and a dwindling number of farms in remote areas, they also log “a lot of windshield time” that can make starting a family challenging, says Joe Armstrong, a Minnesota veterinarian who has spoken about the toll of the outbreak on his bovine-themed podcast, The Moos Room.

Fred Gingrich, executive director of the American Association of Bovine Practitioners, says he is aware of vets being fired: “This disease sometimes put the veterinarian in the middle, between what they feel they should be doing and what the farmer wants them to do.”

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One veterinarian in an impacted state, who knows several of the vets involved, says their firings could be “personality-driven.” He adds that they “have a high need for validation. They’re really high feelers. Maybe if they don’t get the response they need, they get louder.”

But the clampdown on vocal vets has been fueled in part by the growing consolidation of the dairy industry. Where there were once thousands of family farms, there are now a much smaller number of mega-farms. Atop those farms sit vast dairy processors, who control regional markets. One of the largest processors, Select Milk Producers, spun off a brand of milk drinks called Fairlife, which was purchased by Coca-Cola. Smaller dairy farms face little choice but to sell to the processors or perish.

“The whole thing is just the perfect storm,” says Austin Frerick, author of Barons: Money, Power, and the Corruption of America’s Food Industry. “These dairy operators are essentially capital asset managers. It’s so consolidated. For family farmers, there are only one or two buyers of your milk. If you don’t go along with the playbook, your market access is cut off and you go bankrupt.”

And H5N1 was not in the corporate playbook. Dairy farmers, afraid their cows would be quarantined or that they would not be able to sell their milk, simply opted not to test. Some forced veterinarians off their property. “Everyone is so scared shitless. That is what is going on in the background,” says the Western-state veterinarian.

Meanwhile, the USDA was sitting on details about infected farms. Researchers rely on the international data-sharing platform GISAID to track the spread of worrisome viruses, and the USDA’s H5N1 submissions have been both late and frustratingly light on detail. The CDC submits H5N1 sequences and metadata within eight days. Countries like Vietnam and Cambodia move even faster. But the USDA has been sharing the genetic sequences of H5N1 samples an average of 24 days after collection, and those submissions don’t say on what date, or even in which state, each sample was collected. Only later, usually after three to six weeks, does the agency provide that additional information. As a result, the USDA’s data is effectively useless for monitoring in real time how the virus is mutating. “Why can the US CDC provide actionable information while the USDA cannot?” asks a GISAID staffer. “The withholding of such data by other nations would most certainly have triggered political outrage at the highest level in the US.”

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A USDA spokesman defends the agency’s approach, saying it helps to ensure the accuracy of the data and “the high confidence currently placed in our published, curated sequences domestically and in the worldwide research community.”

In late May, trying to break this logjam, a Minnesota veterinarian and professor who studies the spread of influenza viruses, Dr. Marie Culhane, reached out to state veterinarians dealing with farm outbreaks to ask for more detailed information. At the very least, she hoped to obtain the date on which, as well as the region from which, samples had been taken.

“We look at pathways of infection and then we can put in stop measures,” says Culhane. “I was trying to do it in a safe way” that would not identify the farms. “I wasn’t asking for GPS coordinates of a farm so that Vanity Fair could go there and bug them.”

In late May, a state veterinarian wrote back to her on behalf of colleagues from 10 states, giving a hard no: “We will be declining to supply the requested information at this time.”

“We Have Regressed”

In March 2020, as passengers stricken with COVID-19 were marooned on a cruise ship off the California coast, President Trump infamously announced that he didn’t want those infected to come ashore or be tested because “I like the numbers being where they are.”

Today, without nationwide surveillance or a clear understanding of the H5N1 outbreak’s scope, “we are repeating every single mistake” of the last pandemic, says Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory. “The whole adage of ‘don’t take a test because we don’t want to know what the answer is’ is really irritating.”

In May, Medgene informed the USDA that it had an H5N1 vaccine for cows and already had half a million preorders from desperate farmers. To develop the vaccine, the company relied on USDA regulations formulated in 2018 to accelerate vaccine approval in the event of an agricultural emergency.

But as it struggled to get sign-off, the company kept hearing that trade restrictions stood in the way. Meanwhile, the USDA kept stating that vaccine development was still in the early stages. Says Medgene CEO Mark Luecke: “We’re screaming at the top of our lungs, ‘We have an H5N1 vaccine for cattle ready to help farmers and ranchers today!’”

Deeble contends that USDA is “truly supportive” of the effort to develop an H5N1 vaccine for dairy cows. “We’ve invested an extraordinary amount of money into the research to develop a vaccine model” and the needed technology for manufacturers to show a vaccine is effective, he says.

Most cows that contract H5N1 eventually recover with treatment. The same cannot be said for chickens. In order to satisfy the letter of trade agreements that claim no avian influenza is present in America’s poultry stock, entire flocks are “depopped”—euthanized en masse—any time a single bird gets sick.

Since April, the avian influenza running rampant in dairy cows has led to the culling of at least 18.6 million birds, says Dr. Michelle Kromm, a poultry-medicine expert who analyzed data from the USDA and other sources to arrive at that number. Poultry veterinarians “cannot comprehend what is happening,” says Kromm. “With poultry being treated as less important than dairy, the mental health issues that come with killing animals for disease control, the [substantial] economic impact—to just allow it to continue with no end in sight, that’s an untenable situation.”

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In July, the American Association of Avian Pathologists issued a statement calling for a national strategy that adheres to “science-based principles of disease control.”

Taking aim at the limited federal testing order, it said, “The narrow requirement of pre-movement testing of only lactating dairy cows moving interstate is inadequate and overlooks risks that other classes of cattle pose to poultry.”

Meanwhile, Europe’s top influenza researchers have watched the US response unfold with astonishment and dismay. “I thought at the beginning of the outbreak that surely a high-income country with a very good infrastructure, with very well-trained veterinarians and infectious disease people, would be able to contain this virus quite easily,” says Thijs Kuiken, an avian influenza expert at the Erasmus University Medical Center in the Netherlands. “However, that is not the case.”

Deeble says the USDA has been moving as swiftly and aggressively as it can, given its limited authority, which does “not allow us to go and collect whatever information we might want to at any time.” He adds, “The USDA doesn’t own farms.”

It is unclear whether the virus, as it continues to spread and evolve, will ultimately pose a serious threat to human health. But if it does, there could be a battle no less intense than the one still being fought over who should be held responsible for COVID-19. Looking back at the events of 2019, one thing almost everyone agrees on is that China should have been much more transparent about what it knew and when it knew it.

As one White House health official tells Vanity Fair, “Not only have we not learned, we have regressed.”

Additional reporting by Stan Friedman.

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Inside the Bungled Bird Flu Response, Where Profits Collide With Public Health (2)

Special Correspondent

Katherine Eban is a special correspondent at Vanity Fair, covering medical and scientific mayhem. An award-winning investigative journalist, she is the best-selling author of Bottle of Lies: The Inside Story of the Generic Drug Boom. You can follow her on Twitter.

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